Differences in fear of falling and fall risk indicators among white and black older adults: a cross sectional study

Abstract

Background Falling among older adults is common and can cause chronic health complications. This study investigated differences between White and Black community-dwelling older adults in fall history, fear of falling, and indicators of fall risk.Methods All assessments and analyses were conducted in a clinical laboratory at Emory University in the Department of General Medicine and Geriatrics on 84 diverse community-dwelling older adults (White, n=37; Black, n=47). Statistical analyses included one-way ANOVA for continuous variables, the Fisher exact test for categorical variables, the Mann-Whitney-Wilcoxon test for ordinal variables, and an ordinal logistic regression model to examine which factors predicted fear of falling. Measures included fall history, fear of falling, and fall risk indicators. The Montreal Cognitive Assessment, Activities-Specific Balance Confidence Score, Gait Speed, Short Form 12 Physical Component Score and Mental Component Score, fear of falling and quality of life rating scales and demographics questionnaires were administered.Results Falls history was not significantly different between groups. Black participants had significantly fewer years of education (p=.007), lower MoCA scores (p=0.002), and slower fast gait speed (p=0.032) than White participants. However, Black participants reported significantly less fear of falling (p=0.043). Race (Black/White) (p=<0.001), sex (p=0.028), preferred gait speed (p=0.036), and a dichotomous variable of use of assistive device for walking (p=0.023) were significant predictors of fear of falling in the logistical model.Conclusions These factors may explain the observed differences in fear of falling observed between white and black groups in this study. This work offers an explanation of possible factors related to the well-documented yet poorly understood fact that while Black older adults have more risk factors for falling, White older adults tend to fall more frequently and are more afraid of falling.