Is Fear of Falling the Missing Link to Explain Racial Disparities in Fall Risk? Data from the National Health and Aging Trends Study

Singh, Tanvee; Bélanger, Emmanuelle; Thomas, Kali S.

doi:10.1080/07317115.2018.1468377

Cited by 15 publications

(10 citation statements)

References 27 publications

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“…In our multivariable models, we found that FoF was independently associated with being female, white, Medicaid eligible, and having a higher BMI or more medical comorbidities. Prior investigations in older adults with and without VI also detected these associations and reported comparable effect sizes . The association between BMI and FoF in this study suggests that individuals with a higher BMI are more likely to fear falling even when they are no more likely to fall.…”

Section: Discussionsupporting

confidence: 82%

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Ehrlich

Hassan

Stagg

2018

J American Geriatrics Society

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Objectives To determine the prevalence of falls, fear of falling (FoF), and activity limitation due to FoF in a nationally representative study of older adults with self‐reported vision impairment (VI). Design Cross‐sectional analysis of panel survey data. Setting National Health and Aging Trends Study, a nationally representative survey administered annually from 2011 to 2016 to U.S. Medicare beneficiaries aged 65 and older. Participants Respondents (N=11,558) who contributed 36,229 participant observations. Measurements We performed logistic regression to calculate the unadjusted and adjusted prevalence of self‐reported history of more than 1 fall in the past year, any fall in the past month, FoF, and activity limitation due to FoF in participants with and without self‐reported VI. Results The weighted proportion of participants reporting VI was 8.6% (95% confidence interval (CI)=8.0–9.2%). The unadjusted prevalence of more than 1 fall in the past year was 27.6% (95% CI=25.5–29.7%) in participants with self‐reported VI and 13.2% (95% CI=12.7–13.7%) in those without self‐reported VI. In respondents with self‐reported VI, the prevalence of FoF was 48.3% (95% CI=46.1–50.6%) and of FoF limiting activity was 50.8% (95%CI 47.3–54.2%), and in those without self‐reported VI, the prevalence of FoF was 26.7% (95% CI=25.9–27.5%) and of FoF limiting activity was 33.9% (95% CI=32.4–35.4%). The prevalence of all fall and fall‐related outcomes remained significantly higher among those with self‐reported VI after adjusting for sociodemographics and potential confounders. Conclusion The prevalence of falls, FoF, and activity limitation due to FoF is high in older adults with self‐reported VI. This is the first study to provide nationally representative data on the prevalence of fall‐related outcomes in older Americans with self‐reported VI. These findings demonstrate the need to treat avoidable VI and to develop interventions to prevent falls and fall‐related outcomes in this population. J Am Geriatr Soc 67:239–245, 2019.

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Section: Discussionsupporting

confidence: 82%

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Ehrlich

Hassan

Stagg

2018

J American Geriatrics Society

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“…Of demographic variables, higher risks of fall worry with advancing age was expected. The lower fall worry likelihood among Black older adults is consistent with previous study findings (Singh et al, 2020). Another study also found that relative to non-Hispanic Whites, Black older adults had a 30% decreased risk of sustaining a fall and a 40% decreased risk of recurrent falls (Sun et al, 2016).…”

Section: Discussionsupporting

confidence: 92%

Associations Between Changes in Depression/Anxiety Symptoms and Fall Worry Among Community-Dwelling Older Adults

et al. 2022

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Using the 2019 and 2020 National Health and Aging Trend Study, we examined the association between fall worry and changes in depression/anxiety symptoms among community-dwelling older adults age 70+ ( N = 3333). Past-month fall worry in 2020 included any fall worry (30.9%) and activity-limiting fall worry (34.0% of those with any fall worry). Changes in depression/anxiety symptoms referred to an increase or decrease in the Patient Health Questionnaire-4 symptom categories between 2019 and 2020. Those with fall worry, compared to those without, had significantly higher rates of moderate/severe depression/anxiety symptoms in 2019 and increased depression/anxiety symptoms over time. Multivariable analysis results show that increased depression anxiety symptoms were associated with higher risks of any and activity-limiting fall worry, controlling for previous year’s fall worry, fall incidents, and other health- and fall-related covariates. Older adults need to be screened for both depression/anxiety and fall worry. Effective psychosocial and behavioral interventions for both conditions are needed.

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“…Hispanic older adults who fell in 2019 had a higher risk of recurrent falls in 2020-2021. Our finding of no difference in recurrent fall risks between Black and non-Hispanic White older adults significantly adds to the literature as previous studies tended to report lower fall prevalence and fall worry among Blacks (Geng et al, 2017;Singh et al, 2020;Sun et al, 2016). Our finding of higher fall risks among higher income older adults is consistent with previous study findings (Kelekar et al, 2021), although further research is needed to examine the underlying reasons for income-fall associations.…”

Section: Discussionsupporting

confidence: 88%

Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay

et al. 2023

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We used the 2019–2021 U.S. National Health and Aging Trend Study ( N = 3,063, age 70+) and multinomial logistic regression and generalized linear models with Poisson and log link to identify correlates of (1) recurrent falls (2 + falls) over 3 years (2019–2021); and (2) any subsequent fall among those who had a fall in 2019. We also examined the associations between falls and hospitalization in 2021. Results show that those with recurrent falls had greater physical/functional and psychological health problems in 2019, while single fallers over the 3 years were not significantly different from those without a fall. Exercise was associated with a lower likelihood of a subsequent fall among those who fell in 2019. Both a single fall and recurrent falls over the 3 years were associated with a higher risk of hospitalization in 2021. Multifactorial fall preventions including exercise and depression/anxiety treatment are needed to mitigate recurrent fall risks.

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Is Fear of Falling the Missing Link to Explain Racial Disparities in Fall Risk? Data from the National Health and Aging Trends Study

Abstract: These findings should inform public health fall prevention initiatives among community-dwelling older adults.

Cited by 15 publications

References 27 publications

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Associations Between Changes in Depression/Anxiety Symptoms and Fall Worry Among Community-Dwelling Older Adults

Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay

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