Factors associated with and 1-year outcomes of fear of falling in a geriatric post-hip fracture assessment

Abstract

Background Hip fracture causes not only physical injury but also psychological trauma. Fear of falling (FoF) is related to poor recovery, loss of mobility and mortality. There is limited data on the clinical factors affecting post-hip fracture FoF and its consequences. Objective To investigate the factors associated with and 1-year outcomes of post-hip fracture FoF. Methods An observational prospective cohort study. Data were collected on hospital admission, at a geriatric outpatient assessment 4–6 months post-hip fracture and by telephone interviews 1 year after the index fracture. FoF was assessed with a dichotomous single-item question. Logistic regression analyses were conducted to examine the age, gender and multivariable-adjusted association between baseline and the geriatric assessment domains with FoF. Follow-up outcomes included changes in mobility, living arrangements and mortality. Results Of the 916 patients included, 425 (49%) had FoF at the time of their geriatric assessment. These patients were predominantly female and were living alone in their own homes with supportive home care. They scored lower on tests of physical performance. Less FoF was documented in patients with diagnosed cognitive disorders before the index fracture and in those with Clinical Dementia Rating ≥ 1. After adjusting for age and gender, no association was observed between FoF and any of the 1-year follow-up outcomes. Conclusion Post-hip fracture FoF is common and associated with female gender, polypharmacy, poor daily functioning, poor physical performance and depressive mood. Patients with cognitive disorders have less FoF than those without. FoF appears to have no impact on the follow-up outcomes.

Longitudinal associations of concurrent falls and fear of falling with functional limitations differ by living alone or not

“…The results of falls only showed that the risk of mobility limitations was not significant in older adults who lived alone. To date, only few studies have investigated the relationship between living alone, falls, FOF, and mobility ( 42 , 43 ). In general, living alone has an impact on the frequency of falls and the occurrence of FOF in older adults ( 20 , 44 ).…”

The Role of Autopsy and Post-Mortem Investigations in Falling Traumas in the Hospital Environment

“…Falls represent 38% of adverse events in the hospital setting, constituting a relevant event [ 15 ]. A percentage between 4 and 6% of falls causes major injuries, i.e., bleeding, fractures, and subdural hemorrhage [ 16 ]. The compression of the patient’s fall risk in a healthcare facility is an indicator of the quality of the healthcare service and cannot be achieved without specific training of the healthcare personnel to improve the competence in the prevention and management of falls, but also the awareness of the risk [ 17 ].…”

A systematic review of fear of falling and related constructs after hip fracture: prevalence, measurement, associations with physical function, and interventions

“…All studies that performed correlations found a significant, small to large correlation between FoF and function (Table 6). Three cross-sectional studies found associations remained significant after controlling for covariates, at least for some analyses [59][60][61]. Two prospective studies found that FoF does predict future functional performance when assessed a few weeks to 6 months later [18,55].…”