Fear of Falling in Older Adults Living in a Community-Dwelling Facility: Prevalence and Its Impact on Activity Behavior and Physical Function

Abstract

This study examined the prevalence and the impact of fear of falling (FOF) on physical activity (PA), sedentary behavior (PA), and physical function in older adults living in a continuing care retirement community (CCRC). Ninety-three older adults were included and self-reported assessed on PA and SB. Further, participants’ physical function was assessed using a collection of measures of valid objective tests. Independent t test was used to compare the dependent variables between FOF groups, and analysis of covariance (ANCOVA) was used to control for assistive device usage. FOF was prevalent in 47.3% of the sample and PA and SB did not differ between FOF groups (p > .05). ANCOVA revealed that performance on several physical function tests remained significantly better (p < .05) for the no FOF group compared to the yes group. Our findings demonstrated similar levels of PA and SB between FOF groups, but worse physical function for older adults reporting FOF.

Keywords

falls risk factors elderly institutionalized elderly sedentary time

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References

Asai

Oshima

Fukumoto

Yonezawa

Matsuo

Misu

(2022). The association between fear of falling and occurrence of falls: A one-year cohort study. BMC Geriatrics, 22(1), 1–7. https://doi.org/10.1186/s12877-022-03018-2

Belloni

Büla

Santos-Eggimann

Henchoz

Seematter-Bagnoud

(2020). A single question as a screening tool to assess fear of falling in young-old community-dwelling persons. Journal of the American Medical Directors Association, 21(9), 1295–1301. https://doi.org/10.1016/j.jamda.2020.01.101

Carroll

Qualls

S. H.

(2014). Moving into senior housing: Adapting the old, embracing the new. Generations, 38(1), 42–47.

Chen

W. C.

Y. T.

Tung

T. H.

Chen

Tsai

C. Y.

(2021). The relationship between falling and fear of falling among community-dwelling elderly. Medicine, 100(26), Article e26492. https://doi.org/10.1097/MD.0000000000026492

Cohen

(2013). Statistical power analysis for the behavioral sciences. In Statistical power analysis for the behavioral sciences.

da Costa

E. M.

Pepersack

Godin

Bantuelle

Petit

Levêque

(2012). Fear of falling and associated activity restriction in older people. Results of a cross-sectional study conducted in a Belgian town. Archives of Public Health, 70(1), 1. https://doi.org/10.1186%2F0778-7367-70-1

Deandrea

Lucenteforte

Bravi

Foschi

La Vecchia

Negri

(2010). Risk factors for falls in community-dwelling older people: A systematic review and meta-analysis. Epidemiology, 21(5), 658–668. https://doi.org/10.1097/ede.0b013e3181e89905

Deshpande

Metter

E. J.

Bandinelli

Lauretani

B Gwen Windham

L. F.

(2008). Psychological, physical, and sensory correlates of fear of falling and consequent activity restriction in the elderly: The InCHIANTI study. American Journal of Physical Medicine and Rehabilitation, 87(5), 354–362. https://doi.org/10.1097/phm.0b013e31815e6e9b

Dhar

Kaeley

Mahala

Saxena

Pathania

(2022). The prevalence and associated risk factors of fear of fall in the elderly: A hospital-based, cross-sectional study. Cureus, 14(3), Article e23479. https://doi.org/10.7759/cureus.23479

10.

Florence

C. S.

Bergen

Atherly

Burns

Stevens

Drake

(2018). Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society, 66(4), 693–698. https://doi.org/10.1111/jgs.15304

11.

Guralnik

J. M.

Simonsick

E. M.

Ferrucci

Glynn

R. J.

Berkman

L. F.

Blazer

D. G.

Scherr

P. A.

Wallace

R. B.

(1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. The Journals of Gerontology, 49(2), M85-94. https://doi.org/10.1093/geronj/49.2.m85

12.

Huang

W. N. W.

Mao

H. F.

Lee

H. M.

Chi

W. C.

(2022). Association between fear of falling and seven performance-based physical function measures in older adults: A cross-sectional study. Healthcare, 10(6), 1139. https://doi.org/10.3390/healthcare10061139

13.

Jaatinen

Luukkaala

Hongisto

M. T.

Kujala

M. A.

Nuotio

M. S.

(2022). Factors associated with and 1-year outcomes of fear of falling in a geriatric post-hip fracture assessment. Aging Clinical and Experimental Research, 34(9), 2107–2116. https://doi.org/10.1007/s40520-022-02159-z

14.

James

S. L.

Lucchesi

L. R.

Bisignano

Castle

C. D.

Dingels

Z. V.

Fox

J. T.

Hamilton

E. B.

Henry

N. J.

Krohn

K. J.

Liu

Mccracken

Nixon

M. R.

Roberts

N. L. S.

Sylte

D. O.

Adsuar

J. C.

Arora

(2019). The global burden of falls: Global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017. Injury Prevention, 26(Supp 1). i3–11. https://doi.org/10.1136/injuryprev-2019-043286

15.

Jørstad

E. C.

Hauer

Becker

Lamb

S. E.

(2005). Measuring the psychological outcomes of falling: A systematic review. Journal of the American Geriatrics Society, 53(3), 501–510. https://doi.org/10.1111/j.1532-5415.2005.53172.x

16.

Krout

J. A.

Moen

Holmes

H. H.

Oggins

Bowen

(2002). Reasons for relocation to a continuing care retirement community. Journal of Applied Gerontology, 21(2), 236–256. https://doi.org/10.1177/07364802021002007

17.

Lavedán

Viladrosa

Jürschik

Botigué

Nuín

Masot

Lavedán

(2018). Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? PLoS One, 13(3), Article e0194967. https://doi.org/10.1371/journal.pone.0194967

18.

Lee

J. H.

MoonKi Choi

C. O. K.

(2017). Falls, a fear of falling and related factors in older adults with complex chronic disease. Journal of Clinical Nursing, 26(23–24), 4964–4972. https://doi.org/10.1111/jocn.13995

19.

Leilei

Pengpeng

Haagsma

J. A.

Yuan

Yuliang

Xiao

Xin

Cuirong

Linhong

Bannick

M. S.

Mountjoy-Venning

W. C.

Hawley

C. N.

Liu

Smith

James

S. L.

Vos

Murray

C. J. L.

(2019). The burden of injury in China, 1990–2017: Findings from the global burden of disease study 2017. The Lancet Public Health, 4(9), e449–e461. https://doi.org/10.1016/S2468-2667(19)30125-2

20.

Liu

Hou

Sun

Sarah

Szanton

L. C.

P. M. D.

(2021). Fear of falling is more important than previous falls in terms of limiting activities : A longitudinal study. BMC Geriatrics, 21(1), 350. https://doi.org/10.1186/s12877-021-02305-8

21.

Martínez-Arnau

F.M.

Pietro-Contreras

Pérez-Ros

(2021). Factors associated with fear of falling among frail older adults. Geriatric Nursing, 42(5), 1035–1041. https://doi.org/10.1016/j.gerinurse.2021.06.007

22.

Moreland

Ramakrishna Kakara

A. H.

(2020). Trends in nonfatal falls and fall-related injuries among adults aged ≥65 years — United States, 2012–2018. Morbidity & Mortality Weekly Report, 69(27), 875–881. https://doi.org/10.15585/mmwr.mm6927a5

23.

Ogonowska-Slodownik

Morgulec-Adamowicz

Geigle

P. R.

Kalbarczyk

Kosmol

(2022). Objective and self-reported assessment of physical activity of women over 60 Years old. Ageing International, 47(2), 307–320. https://doi.org/10.1007/s12126-021-09423-z

24.

Okoye

E.C

Okosile

C.O

Maruf

F.A

Onwuakagba

I.U

Mgbeojedo

U.G

(2021). Falls and fear of falling among older adults in an assisted-living facility: A qualitative and foundational study for intervention development in a developing country. Archives of Gerontology and Geriatrics, 94(2021), 104375. https://doi.org/10.1016/j.archger.2021.104375

25.

Park

J.H.

Cho

Shin

JH.

Kim

Park

SB.

Choi

BY.

Kim

M.J.

(2014). Relationship among fear of falling, physical performance, and physical characteristics of the rural elderly. American Journal of Physical Medical Rehabilitation, 93(5), 379–386. https://doi.org/10.1097/phm.0000000000000009

26.

Pirrie

Saini

Angeles

Marzanek

Parascandalo

Agarwal

(2020). Risk of falls and fear of falling in older adults residing in public housing in Ontario, Canada: Findings from a multisite observational study. BMC Geriatrics, 20(1), 1–8. https://doi.org/10.1186/s12877-019-1399-1

27.

Podsiadlo

Richardson

(1991). The timed “up and Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

28.

Ramsey

K. A.

Zhou

Rojer

A. G.M.

Esmee

Reijnierse

A. B. M.

(2022). Associations of objectively measured physical activity and sedentary behaviour with fall-related outcomes in older adults: A systematic review. Annals of Physical and Rehabilitation Medicine, 65(2), 101571. https://doi.org/10.1016/j.rehab.2021.101571

29.

Rikli

R. E.

Jones

C. J.

(1999). Development and Validation of a Functional Fitness Test for Community-Residing Older Adults. Journal of Aging and Physical Activity, 7(2), 129–161. https://doi.org/10.1123/japa.7.2.129

30.

Scheffer

A. C.

Schuurmans

M. J.

Van dijk

Van der hooft

De rooij

S. E.

(2008). Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37(1), 19–24. https://doi.org/10.1093/ageing/afm169

31.

Schoene

Heller

Aung

Y. N.

Sieber

C. C.

Kemmler

Freiberger

(2019). A systematic review on the influence of fear of falling on quality of life in older people: Is there a role for falls? Clinical Interventions in Aging, 2019(14), 701–719. https://doi.org/10.2147/cia.s197857

32.

Sebastião

(2020). Activity behavior and cognitive performance in older adults living in a senior housing facility: The impact of frailty status. Aging Clinical and Experimental Research, 32(4), 703–709. https://doi.org/10.1007/s40520-019-01254-y

33.

Sebastião

Pak

Benner

Nakamura

P. M.

Papini

C. B.

(2019). Magnitude and composition of sedentary behavior in older adults living in a retirement community. Journal of Community Health, 44(4), 805–814. https://doi.org/10.1007/s10900-019-00633-w

34.

Gao

Zhang

Tang

Song

Mao

(2021). Prevalence of fear of falling and its association with physical function and fall history among senior citizens living in rural areas of China. Frontiers in Public Health, 9(December), 1–7. https://doi.org/10.3389/fpubh.2021.766959

35.

Van Haastregt

J. C. M.

Zijlstra

G. A. R.

Van Rossum

Van Eijk

J. T. M.

De Witte

L. P.

Kempen

G. I. J. M.

(2007). Feasibility of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity in community-living older people: A process evaluation. BMC Health Services Research, 7(2007), 156. https://doi.org/10.1186/1472-6963-7-156

36.

Visser

Koster

(2013). Development of a questionnaire to assess sedentary time in older persons - a comparative study using accelerometry. BMC Geriatrics, 13(1), 80. https://doi.org/10.1186/1471-2318-13-80

37.

Washburn

Smith

Jette

Janney

(1993). The physical activity scale for the elderly (PASE): Development and evaluation. Journal of Clinical Epidemiology, 46(2), 153–162. https://doi.org/10.1016/0895-4356(93)90053-4