Relationship Between Fear of Falling, Fear‐Related Activity Restriction, Frailty, and Sarcopenia

Abstract

OBJECTIVES: To determine the prevalence of fear of falling (FOF) and fear-related activity restriction (FAR) and their association with frailty, sarcopenia, gait speed and grip strength, cognitive impairment, depression, social isolation, self-perceived health, and vision. DESIGN: Observational cross-sectional study. SETTING: Community. PARTICIPANTS: A total of 493 community-dwelling older adults, 60 years and older. MEASURES: FOF and FAR were assessed using validated single closed-ended questions. Questionnaire was administered to evaluate frailty (FRAIL scale-Fatigue, Resistance, Aerobic, Illness, and Loss of Weight), sarcopenia (SARC-F-lifting and carrying 10 pounds, walking across a room, transferring from bed/chair, climbing a flight of 10 stairs, and frequency of falls in the past 1 year), social isolation (six-item Lubben Social Network Scale), depression (Even Briefer Assessment Scale), cognition (Chinese Mini-Mental State Examination), and perceived general health and pain (The EuroQol-5 Dimension (EQ-5D) and EQ visual analogue scale (EQ VAS)). Binary logistic regression was performed to determine the influence of sociodemographic, medical, functional, and cognitive variables on FOF with/without FAR. RESULTS: Prevalence of FOF was 69.2%, and among them, 38.4% had FAR. Prevalence of FOF with or without FAR in those with sarcopenia was 93.3% and in prefrail/frail was 76.6%. FOF was significantly associated with prefrail/frail (odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.26-3.73), depression (OR = 4.90; 95% CI = 1.06-22.67), number of medications (OR = 1.28; 95% CI = 1.03-1.59), and female sex (OR = 3.54; 95% CI = 1.82-6.90). FOF + FAR was associated with depression (OR = 5.17; 95% CI = 1.84-14.54) and sarcopenia (OR = 8.13; 95% CI = 1.52-43.41). CONCLUSION: FOF with/without FAR is highly prevalent among community-dwelling older adults, especially in those with sarcopenia, prefrailty, and frailty, with significant negative impact on function, quality of life, social network, and mental health. Further research is needed to investigate the value of population-level screening, causal relationship, and efficacy of comprehensive intervention strategies.

Exercise, Aging and Frailty: Guidelines for Increasing Function

“…Frailty is a dynamic clinical state of decreased functional reserve which increases individual's vulnerability to develop negative health-related events such as disability and/or mortality when exposed to external stressor (18). It is associated with a variety of negative outcomes including cognitive decline, falls, fear of falling, hospitalisation, increased healthcare utilisation, polypharmacy, institutionalisation, and mortality (19,20). Frailty is not synonymous with disability or comorbidities, and almost half of frail older adults are still independent.…”

Discharge transition experienced by older Korean women after hip fracture surgery: a qualitative study

“…Older adults continued to complain of fear of falling even 3–6 months after hip fracture surgery [ 50 ], and after completion of a 4–6 weeks rehabilitation program [ 51 ]. Fear of falling was also more frequent in women than in men [ 52 ]. Considering that fear of falling is a factor that hinders walking ability from the onset, assessments and interventions to reduce fear of falling should be initiated as soon as possible after surgery.…”

Associação entre aspectos físicos-funcionais, comportamentais e de saúde com o medo de cair em idosos comunitários

“…36,38 Outro fator avaliado neste estudo foi a associação entre a sarcopenia provável e o medo em cair. Dados similares foram observados por alguns estudos [39][40][41] e confirmaram o risco aumentado do medo em cair em idosos com sarcopenia. Uma possível hipótese relacionada a essa associação deve-se ao menor desempenho físico e as alterações resultantes da sarcopenia na capacidade física, já que se trata de uma condição que leva a perda da força e massa muscular e acarreta problemas ao equilíbrio corporal estático e dinâmico.…”