Frailty, falls and poor functional mobility predict new onset of activity restriction due to concerns about falling in older adults: a prospective 12-month cohort study

Abstract

Purpose Concerns about falling are common in older adults and often cause activity restriction. This can lead to physical deconditioning, falls and social isolation. However, not every concerned older adult will restrict their activities. This 12-month longitudinal study investigated the physical and psychosocial factors that predict the new onset of activity restriction due to concerns about falling in older people. Methods Participants were 543 older adults (Mage = 80.3 ± 4.4 years, range: 75–98) who did not report activity restriction due to concerns about falling at Timepoint-1 (negative response to the following question: “Do concerns about falling stop you going out-and-about?”). Participants completed a battery of physical and psychological assessments at Timepoint-1. Using binary logistic regression, we then assessed which of these variables predicted whether participants reported having started restricting their activity due to concerns about falling at the 12-month follow-up (Timepoint 2). Results 10.1% of the sample started to restrict activity due to concerns about falling at Timepoint 2. Three key predictors significantly predicted activity restriction group status at 12-month follow-up: greater frailty at Timepoint-1 (Fried Frailty Index; OR = 1.58, 95% CI 1.09–2.30), experiencing a fall between Timepoint-1 and 2 (OR = 2.22, 95% CI 1.13–4.38) and poorer functional mobility at Timepoint-1 (Timed up and Go; OR = 1.08, 95% CI 1.01–1.15). Conclusions Frailty, experiencing a fall and poorer functional mobility all predicted the onset of activity restriction due to concerns about falling. Clinicians working in balance and falls-prevention services should regularly screen for frailty, and patients referred to frailty services should likewise receive tailored treatment to help prevent the development of activity restriction due to concerns about falling.

Physical-activity interventions to reduce fear of falling in frail and pre-frail older adults: a systematic review of randomized controlled trials

“…Pre-frail and frail older adults are at an even significantly higher risk of experiencing falls and developing FoF [ 13 ] and frail older adults are at 1.8 times higher risk of falls compared to their robust counterparts [ 14 ]. Frailty in older adults leads to concern about falling and, as a result, limitation of their daily activities [ 15 ]. FoF seems to be prevalent among community-dwelling frail older adults, with a significant negative impact on their physical function, quality of life, and social interaction [ 16 ].…”

Innovation in Digital Health Interventions for Frailty and Sarcopenia

“…Frail and sarcopenic older adults with less muscle strength are at a high risk of falling, and once they fall, they may become fearful and less physically active, which may further reduce their muscle strength [ 23 ]. Therefore, the detection and prevention of falls in frail and sarcopenic older adults is an important issue.…”