Is fall self‐efficacy an independent predictor of recurrent fall events in older adults? Evidence from a 1‐year prospective study

Abstract

Falls, which are prevalent among older adults, may not only cause severe physical injuries, but also lead to low fall self-efficacy (FSE). Low FSE is associated with restricted activity, which putatively increases risk of future falls. However, emerging studies have failed to confirm this association. Furthermore, the interplay between age, gender, and fall history with falls has not been adequately addressed in adults aged 70 years or older. The aims of this secondary analysis were to: (1) prospectively explore the association of FSE and fall events considering age, gender, and fall history, and (2) examine the characteristics of fall events and fall-related outcomes. Forty-seven community-dwelling adults over 70 years of age were followed for about 12 months. During the follow-up, 22 participants with low FSE experienced 119 fall events whereas 25 participants with high FSE reported 106 fall events. Among fallers, 72.3% (n = 34) experienced recurrent fall events. About

The association between falls and autonomy in older adults is mediated by self-efficacy

“…Also, impairments in sensorimotor functioning may lead to fear of falls [5] and thus reduction in self-efficacy. Older adults with a higher self-efficacy are at a lower risk of falling and fallers with a lower self-efficacy might be less active in comparison to fallers with greater self-efficacy [16]. This fits with observations by Warner et al [17] and Ryan and Deci [11] who revealed greater autonomy in people with higher self-efficacy.…”

“…This assumption is in line with Loft et al [15] who indicated that lower fall-related self-efficacy is associated with a higher number of falls in the past [15] and with Warner et al [17] and Ryan and Deci [11] who revealed greater autonomy in people with higher self-efficacy. A recent study by Yang and Pepper [16] confirmed that higher fall-related self-efficacy was significantly correlated with a lower number of falls [16]. Dadgari et al [40] further reported a significant association between low fall-related self-efficacy and high levels of fear of falling and a significant role of self-efficacy as a mediator between falls and fear of falling.…”

“…With our study we followed three aims to replicate and extend the analyses by Hajek and König [25]: First, we aimed at exactly replicating their findings with data from a more recent wave of the same data set (the sixth wave of the DEAS from 2017). Second, as self-efficacy is associated with both, falls and autonomy [2,[15][16][17]24], we assumed that self-efficacy would not only moderate but also mediate the association between falls and autonomy and extended the analysis accordingly. Third, based on the revealed association between falls and cognitive status [21] and the importance of cognitive functioning for ADL [23] we further examined whether cognitive function instrumentalized as performance in the Digit Symbol Substitution Test (DSST) [27] would significantly moderate the association between a history of falls and autonomy.…”

Health-Related Physical Fitness as a Risk Factor for Falls in Elderly People Living in the Community: A Prospective Study in China

“…In this cohort, ∼12% of subjects reported fall event during the 1-year observation. This rate is relatively low compared to other prospective studies (31,32). The baseline assessment had excluded the older people who had impaired physical mobility and health-related inactivity.…”

Fall risk question-based tools for fall screening in community-dwelling older adults: a systematic review of the literature

“…The study design was cross-sectional in 8 studies [16][17][18][19][20][21][22][23] , retrospective in 1 24 , prospective in 10 [25][26][27][28][29][30][31][32][33][34] (with a followup period from 3 months to 3 years) and both retro-and prospective in 1 study 35 . Overall, the majority of the participants of the included studies were females with a percentage ranging from 45% to 84%.…”