Physical Function and Health Status among Seniors with and without a Fear of Falling

Abstract

Background: Fear of falling (FF) is pervasive among older people and is an independent risk factor for decreased mobility and loss of quality of life. Although it is a serious health concern, little is known about the severity of the physical and health-related deficits in high-functioning fearful seniors. Objective: This study examined the physical correlates of FF in community-dwelling seniors in relation to their non-fearful counterparts and also explored the relevance of recent fall history. Subjects: Twenty-five volunteers who stated that they had curtailed their activities due to a FF and who reported themselves to be healthy participated. Non-fearful, age- and gender-matched subjects were also recruited and served as a comparison group. Methods: This cross-sectional study had participants come to the laboratory on one occasion for about 1.5 h. Limits of balance stability, walking speed, and lower limb muscle strength were measured in random order. In addition, the SF-36, the Activities-specific Balance Confidence (ABC) scale and the Human Activity Profile questionnaires were completed to provide measures of heath status, FF and activity levels, respectively. Results: Subjects with a FF had lower ABC scores (69.8 ± 10.2) than controls (90.2 ± 7.9; p < 0.001), and although they reported activity curtailment, the groups presented similar activity profiles (p > 0.05). Balance ability was not compromised in seniors with a FF, although their walking speed was slower than that of control subjects (p < 0.004). Lower limb weakness was significant in the FF group, which also reported low physical health. Perceived physical health, activity and hip flexor torque in combination accounted for almost 62% of the variance in ABC scores. Secondary analysis of the data from the FF group revealed a tendency for those who had fallen in the past year to restrict their limits of stability compared to those who had not fallen; though generally the effect sizes were small to moderate. Conclusions: The marked deficits in strength and health status found among seniors living independently in the community, who are in good health, but report being fearful of falling underscores the seriousness of FF as a potential health risk factor in the well elderly.

Six-Minute Walk Test for Persons with Mild or Moderate Disability from Multiple Sclerosis: Performance and Explanatory Factors

“…This result is consistent with studies of non-disabled, community-dwelling older adults, which found that those with reduced balance confidence demonstrated decreased lower-extremity strength and walking speed. 55,56 Likewise, several other studies of older community-dwelling individuals reported an association between 6MWT and measures of physical performance, activities of daily living, or selfreported activity. 14,19,57 Savci et al reported that functional independence in carrying out activities of daily living (Barthel Index) explained 61% of the variance in 6MWT performance in a similar group (EDSS < 6.5) of individuals with MS. 24 While they did not include other measures of physical performance or balance in their regression modelling, adding baseline HR and FSS to their model explained 81% of the variance in 6MWT distance (6% explained by the FSS).…”

Reliability of the Chinese version of the Activities-specific Balance Confidence Scale

“…With the increasing flow of people between different countries, it is critical for clinicians to overcome language barriers and provide the best care to all patients. In the area of balance confidence, many studies have shown that Caucasian people have problems with their balance confidence [17][18][19][20][21][22][23][24], but we have been unable to obtain valid information from the Chinese population in this area because of a lack of reliable translated tools. Thus, there is need for balance confidence tools to be translated into the Chinese language.…”

Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults

“…Existing studies have found reduced gait speed [8][9][10], reduced step or stride length [9,11], increased step width and increased double support phase (DSP) [9] in those with FOF but similar changes are observed with increasing age [12,13], depression [14] and with a history of falls [15], all of which are also associated with FOF. Rochat et al [16] found similar gait changes between groups with no FOF, FOF alone and FOF with activity restriction but while the differences between the no FOF and FOF alone groups were fully explained by confounding variables, those with FOF and activity restriction had decreased gait performance and increased gait variability independent of health and functional status.…”