Associations of Falls with Quality of Life and Correlated Factors in Community-Dwelling Older Adults: A Two-Wave Cohort Study

Abstract

Background Falls contribute to disability and burden of care among older adults. Studies of fall-related impacts on quality of life (QOL) are warranted for future prevention interventions. Methods Fall-related data were collected from adults aged 70 years and above using questionnaire interviews in the 1996 and 1999 surveys at Hunei community in southern Taiwan. Their QOL was measured using the Short Form 36 Health Survey (SF-36) and World Health Organization Quality of Life questionnaire (WHOQOL-BREF) in the 1999 follow-up only. The bilateral relationship among fall category, selected covariates (i.e., age, sex, number of difficulties in performing activities of daily living (ADLs) or instrumental ADLs, number of comorbidities, Geriatric Depression Scale (GDS) scores, Mini-Mental Stated Examination (MMSE) scores, fear of falling, and Physical Activity Scale for the Elderly (PASE) scores), and mean QOL scores were investigated. Hierarchical linear regression models were tested to examine the associations between fall frequency and QOL with sequential entry of explanatory variables. The final models were established by substituting fall category for fall frequency. Results Fall category was significantly associated with physical-related subscale scores, except body pain. Almost every QOL score revealed a negative association with the number of comorbidities, GDS scores, and fear of falling; however, a positive association with MMSE and PASE scores was observed. Conclusions Future prevention interventions should target common risk factors of both QOL and falls among older people, including control of comorbidities, depressive symptoms, cognitive impairment, and inactivity.