Objectives
To measure the prevalence of fear of falling in older adults at the time of long-
term care (LTC) enrollment and identify potentially treatable risk factors for low
fall related self-efficacy.
Design
Prospective cohort study.
Setting
Three LTC programs in Upstate New York.
Participants
112 new enrollees in LTC, aged 55 or older, who passed a cognitive screen.
Measurements
Self-reported falls, the falls efficacy scale (FES), medical conditions, the short
geriatric depression scale, and physical performance measures (Berg balance scale,
hip flexor, knee extensor and grip strength, gait speed and a six-minute walk).
Results
Of the 54 subjects (48.2%) who reported fear of falling, 41 (75.9%) reported activity
modification secondary to fear. Fearful subjects were more likely to be female (P = .003), report low back pain (P = .030) and lower extremity arthritis (P = .037). Fearful subjects were weaker at the hip (P < .001) and knee (P = .001), and had shorter six-minute walk distances. Subjects with better FES scores
had better Berg scores (P < .001), had greater hip and knee strength, had faster gait speeds and walked further
in six minutes (P < .001, P = .006, P = .001 and P = .001 respectively). Subjects with low FES scores and fearful subjects were more
likely to have depressive symptoms (P = .003, P = .044, respectively).
Conclusion
Falls and fear of falling are more common in new LTC enrollees than in previously
described community dwelling and SNF cohorts. Attention to associated characteristics
like depression, arthritis, low back pain and lower extremity weakness may identify
opportunities to reduce fear and improve patient safety during this transitional period.
Keywords
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© 2007 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
