Fear of falling is as important as multiple previous falls in terms of limiting daily activities: a longitudinal study

Liu, Minhui; Hou, Tianxue; Li, Yuxiao; Sun, Xiaohao; Szanton, Sarah L.; Clemson, Lindy; Davidson, Patricia M.

doi:10.1186/s12877-021-02305-8

Cited by 54 publications

(43 citation statements)

References 38 publications

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“…A systematic review has shown that individuals with FoF have more than double the risk of falling than those without FoF [ 6 ]. Additionally, some studies reveal that FoF is associated with various changes, which increase the risk of falls (e.g., inappropriate attention allocation, fixed vision trajectory, and an inactive lifestyle) [ 7 – 9 ]. Considering the strong association between FoF and occurrence of falls, it is important for health-related workers in the community to obtain FoF information.…”

Section: Introductionmentioning

confidence: 99%

The association between fear of falling and occurrence of falls: a one-year cohort study

Asai

Oshima²,

Fukumoto

et al. 2022

BMC Geriatr

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Background Both multiple fall experiences and fear of falling (FoF) would make people susceptible to another fall; however, the associations are unknown. This study investigates the association of FoF with fall occurrence among older adults according to their fall history. Methods In this study, we adopted a longitudinal observational design. We visited 20 community centers to recruit 1,025 older adults (aged 65 years or older). At baseline, FoF was assessed using a single-item questionnaire. The number of falls in the past year was obtained via a self-questionnaire and participants were classified into three fall history groups (0: non-faller, 1: single faller, 2 or more: multiple faller). After a year of following-up, the number of falls during the year was considered as the main outcome. Poisson regression models clarified the influence of FoF on fall occurrence during the one-year follow-up, according to the participants’ fall history. Results The final sample comprised 530 individuals (follow-up rate: 530/801, 66.4%). Fall history, FoF, and interaction between multiple fallers and FoF were significant in the adjusted statistical model (rate ratio [95% confidence interval]: single faller = 2.81 [1.06, 6.30], multiple faller = 13.60 [8.00, 23.04], FoF = 3.70 [2.48, 5.67], multiple faller*FoF = 0.37 [0.20, 0.68]). Conclusions We found that FoF was associated with the occurrence of falls in community-dwelling older adults. However, its association was lower in multiple fallers.

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Section: Introductionmentioning

confidence: 99%

The association between fear of falling and occurrence of falls: a one-year cohort study

Asai

Oshima²,

Fukumoto

et al. 2022

BMC Geriatr

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“…As described above, only few studies have investigated the persistent or/and transient nature of FoF in older CD persons already having experienced a fall or injurious fall in a longitudinal study design [ 2 , 11 ]. One might speculate that over time the detrimental experience of a fall could be reduced and that FoF could also decrease or even disappear.…”

Section: Introductionmentioning

confidence: 99%

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

Freiberger

Fabbietti²,

Corsonello³

et al. 2022

BMC Geriatr

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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).

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“…Psychosocially, falls may cause fear of falling, which is a relevant fall risk factor itself, with prevalence ranging between 30 to 73% [ 12 , 13 ]. Fear of falling may result in reduced physical activity [ 14 ], and affect social participation, thus, increasing the risk of social isolation and loss of independence [ 15 , 16 ]. Therefore, the manifold consequences of falls do not only impair quality of life, but also increase the risk of further diseases and disorders such as depression and dementia [ 16 – 18 ], potentially forming a vicious circle.…”

Section: Introductionmentioning

confidence: 99%

Sentinel fall presenting to the emergency department (SeFallED) – protocol of a complex study including long-term observation of functional trajectories after a fall, exploration of specific fall risk factors, and patients’ views on falls prevention

et al. 2022

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Background Falls are a leading cause for emergency department (ED) visits in older adults. As a fall is associated with a high risk of functional decline and further falls and many falls do not receive medical attention, the ED is ideal to initiate secondary prevention, an opportunity generally not taken. Data on trajectories to identify patients, who would profit the most form early intervention and to examine the impact of a fall event, are lacking. To tailor interventions to the individual’s needs and preferences, and to address the whole scope of fall risks, we developed this longitudinal study using an extensive assessment battery including dynamic balance and aerobic fitness, but also sensor-based data. Additionally, participative research will contribute valuable qualitative data, and machine learning will be used to identify trips, slips, and falls in sensor data during daily life. Methods This is a mixed-methods study consisting of four parts: (1) an observational prospective study, (2) a randomized controlled trial (RCT) to explore whether a diagnostic to measure reactive dynamic balance influences fall risk, (3) machine learning approaches and (4) a qualitative study to explore patients’ and their caregivers’ views. We will target a sample size of 450 adults of 60 years and older, who presented to the ED of the Klinikum Oldenburg after a fall and are not hospitalized. The participants will be followed up over 24 months (within four weeks after the ED, after 6, 12 and 24 months). We will assess functional abilities, fall risk factors, participation, quality of life, falls incidence, and physical activity using validated instruments, including sensor-data. Additionally, two thirds of the patients will undergo intensive testing in the gait laboratory and 72 participants will partake in focus group interviews. Discussion The results of the SeFallED study will be used to identify risk factors with high predictive value for functional outcome after a sentinel fall. This will help to (1) establish a protocol adapted to the situation in the ED to identify patients at risk and (2) to initiate an appropriate care pathway, which will be developed based on the results of this study. Trial registration DRKS (Deutsches Register für klinische Studien, DRKS00025949). Prospectively registered on 4th November, 2021.

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Fear of falling is as important as multiple previous falls in terms of limiting daily activities: a longitudinal study

Cited by 54 publications

References 38 publications

The association between fear of falling and occurrence of falls: a one-year cohort study

The association between fear of falling and occurrence of falls: a one-year cohort study

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

Sentinel fall presenting to the emergency department (SeFallED) – protocol of a complex study including long-term observation of functional trajectories after a fall, exploration of specific fall risk factors, and patients’ views on falls prevention

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