Transient versus stable nature of fear of falling over 24 months in community-older persons with falls– data of the EU SCOPE project on Kidney function

Abstract

Background Fear of falling (FoF) is an important risk factor for falls among older people. The objectives of our investigations were: a.) to present characteristics of older community-dwelling (CD) fallers with persistent or transient FoF (P-FoF or T-FoF) over 12 months, and b.) to investigate clinical predictors of P-FoF and T-FoF and c.) to explore differences between P-FoF and T-FoF. Methods Our series consisted of 389 older people reporting a fall or injurious fall at baseline and during 24 months follow-up participating in a multicenter prospective study. T-FoF was defined as participants reported “not at all” at baseline and “somewhat/fairly/very concerned” at follow-up, or “not at all” at follow-up, and “somewhat/fairly/very concerned” at baseline, and P-FoF was defined as participants answered “somewhat/fairly/very concerned” in both assessments at baseline and at follow-up. The association between risk factors and T-FoF or P-FoF was investigated by logistic regression analysis. Results The mean age of fallers in our sample was 79.0 years (SD 6.0), and 54.2% were females. Out of 389 older adults with a fall history at baseline, 83 participants (21.3%) did not report any FoF over time, P-FoF and T-FoF were observed in 42.7% and 35.9% of participants, respectively. After adjusting for potential confounders (e.g. age, gender), osteoporosis (OR = 2.04, 95%CI = 1.03–4.05) and impaired physical performance (OR = 2.38, 95%CI = 1.12–5.03) were significant predictors of T-FoF vs No-FoF. Osteoporosis (OR = 2.68, 95%CI = 1.31–5.48), depressive symptoms (OR = 3.54, 95%CI = 1.23–10.1) and living alone (OR = 2.44, 95%CI = 1.17–5.06) were significantly associated with P-FoF vs No-FoF. When comparing T-FoF and P-FoF, female gender (OR = 1.95, 95%CI = 1.16–3.27), BMI (OR = 1.08, 95%CI = 1.02–1.14), overall comorbidity (OR = 1.07, 95%CI = 1.02–1.13) and depression (OR = 2.55, 95%CI = 1.33–4.88) were significant predictors of P-FoF. Conclusions T-FoF and P-FoF may be predicted by different sets of risk factors among older fallers. Thus, fallers should be screened for FoF especially when carrying specific risk factors, including female gender, osteoporosis, depression, living alone, impaired physical performance, BMI, comorbidity. These findings may be helpful in designing tailored intervention to blunt the risks related to consequence of FoF among older people experiencing falls. Trial registration The SCOPE study was registered prospectively at clinicaltrials.gov (NCT02691546; 25/02/2016).

Fear of falling in older adults: a multiple correspondence analysis of sociodemographic, physical and mental health related factors

“…First, these results highlight that the physical aspect has a preeminent role in influencing the FoF, together with just one component of the mental health (i.e., self-acceptance). With regards to the BMI effect, overweight/obese people are generally more worried about falling, and this is in line with some studies assessing anthropometrics as a possible influencing factor 29,30 . Both the measured (musculoskeletal disease, upper body strength, and mobility and balance) and perceived physical health aspects were predictors of FoF.…”

Nutritional Status Predicts Injurious Falls Among Community-Dwelling Older Adults: Does Sex Matter?

“…Fall injuries are one of the leading causes of death among community-dwelling older adults (Moreland et al, 2020). Injurious falls can lead to poor physical and mental health (Freiberger et al, 2022; Moreland et al, 2020) and increase the chances of admission to long-term care (Gill et al, 2013; Tinetti & Williams, 1997). The cost of fall-related care and rehabilitation among older adults will also increase substantially as the population ages (Burns et al, 2016).…”

Discrepancies in perception of fall risk between patients with subacute stroke and physical therapists in a rehabilitation hospital: a retrospective cohort study

“…Fear of falling is associated with a risk of falling in patients with stroke and in older people ( Jalayondeja et al, 2014 ; Freiberger et al, 2022 ). The Fall Efficacy Scale-International (FES-I) is a measure of patients’ own assessment of their fall risk ( Yardley et al, 2005 ), and its score has been shown to be associated with fall occurrence in patients with stroke ( Azad et al, 2014 ; Faria-Fortini et al, 2021 ).…”