Fear of falling and cognitive impairment in elderly with different social support levels: findings from a community survey in Central Vietnam

Abstract

Background: Fear of falling (FoF) in the elderly is one of the major public health concerns in this era of aging of the population. As there is limited evidence on how cognitive function may differ by social support level in relation to FoF among the elderly, this cross-sectional study aims to investigate the prevalence of FoF and the associations between cognitive impairment and FoF by the social support level, after adjustments for potential confounders. Methods: Data from the "Health needs assessment of elderly in Thua Thien Hue Province, Vietnam in 2018" survey of 725 elderly aged 60 years or older were used for analysis. FoF was assessed using the Fall Efficacy Scale-International. High FoF was defined as a score above 28. The Multidimensional Scale of Perceived Social Support was used to measure the perception of support. Logistic regression analysis was performed to investigate the association between cognitive function and FoF by social support levels (p < 0.05). Results: The prevalence of high FoF among the elderly was 40.8%. Female gender, advanced age, a marital status of single or formerly married, living alone, history of injury, history of falls, chronic diseases (arthritis and/or hypertension), limitations of the IADL and BADL, visual difficulty and walking difficulty, low social support, and cognitive impairment were all significantly associated with a high FoF. After adjustments for the age, gender, marital status, history of falls and health-related factors, cognitive impairment remained significantly associated with a high FoF among the elderly with a low to moderate social support level (OR = 2.97, 95% CI 1.49-5.89), but not in those with a high social support level. Conclusions: A high FoF was associated with impairment of cognitive function among the elderly who perceived themselves as having low or moderate support levels, even after adjustments for socio demographic and physical functional factors. However, this association was not observed among the elderly who perceived themselves as having high social support levels. Fall prevention programs for the elderly with various levels of social support should be carefully devised, keeping in mind the cognitive function levels of the target recipients.

Relationship Between Fear of Falling, Mental Wellbeing, and Depression in the Elderly With Cardiovascular Disease: A Predictive Study

“…This may be due to women generating more chronic diseases, musculoskeletal problems, as well as anatomical and biopsychological gender differences [28]. Besides, according to other studies, aging is significantly associated with increased fear of falling [12,29]. Considering the longer life expectancy of older women than men, the high fear of falling in older women can be justified.…”

“…The reason for the difference in the level of fear of falling of elderly living in urban and rural regions could be attributed to differences in their lifestyle as well as the quality of life [30]. Due to the integrity of individuals' culture in rural areas, older people receive higher social support from family, neighbors, or friends, i.e., effective in improving their wellbeing and physical health, resulting in better cognitive function and mental wellbeing; consequently, such conditions reduce fear of falling in the elderly living in villages [12]. Arruda addressed no difference in the risk of falls between urban-and rural-living elderly [31].…”

“…Fear of falling is considered a mental state; in different societies, 25%-55% of the elderly express it even without a history of falling [9,11]. Fear of falling is defined as a constant concern about falling, leading to the Activities of Daily Living (ADL) avoidance and physical problems [12]. The causes of falls are multifaceted.…”

Increased anxiety about falls and walking ability among community‐dwelling Japanese older adults during the COVID‐19 pandemic

“…FOF is associated with frailty, sarcopenia, and impaired cognitive function. 16,[20][21][22] Maintenance of daily physical activity prevents anxiety, including FOF, and prevents deterioration of physical function. 23 Therefore, maintaining physical activity and psychological care is important for preventing frailty syndrome and disease onset due to the COVID-19 pandemic.…”

Physical Activity and its Influencing Factors in Community-Dwelling Older Adults With Dementia: A Path Analysis

“…One of the predominant features of dementia is deterioration in undertaking activities of daily life (ADL), which is reflected in aspects of physical limitation and cognitive deficiency (Gélinas et al, 1999). These might also impede patients' capacity to participant in exercise, potentially increasing their risk of falling and exacerbating caregivers' fear for their exercise safety (Cedervall et al, 2015;Stubbs et al, 2014;van Alphen et al, 2016b;Vo et al, 2020). However, previous studies showed inconsistent results about the effect of the capacity to undertake ADL on the level of PA (Stubbs et al, 2014).…”