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Predictors of Incident Fear of Falling in Community-Dwelling Older Adults

  • Giulia Rivasi
    Correspondence
    Address correspondence to Giulia Rivasi, MD, Geriatric Intensive Care Medicine, Hypertension Centre, Syncope Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Viale Pieraccini 6, 50139, Florence, Italy.
    Affiliations
    Syncope Unit and Referral Centre for Hypertension in the Elderly, Department of Geriatrics and Geriatric Intensive Care Unit, Careggi Hospital and University of Florence, Italy
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  • Rose Anne Kenny
    Affiliations
    Discipline of Medical Gerontology and Falls and Syncope Unit, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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  • Andrea Ungar
    Affiliations
    Syncope Unit and Referral Centre for Hypertension in the Elderly, Department of Geriatrics and Geriatric Intensive Care Unit, Careggi Hospital and University of Florence, Italy
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  • Roman Romero-Ortuno
    Affiliations
    Discipline of Medical Gerontology and Falls and Syncope Unit, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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Published:October 11, 2019DOI:https://doi.org/10.1016/j.jamda.2019.08.020

      Abstract

      Objectives

      Fear of falling (FoF) is common in older people and may lead to physical decline, disability, poor quality of life, and falls. Several risk factors for FoF have been identified in cross-sectional studies, but evidence on predictors of its incidence is scarce. We investigated the latter in community-dwelling older people undergoing a comprehensive geriatric assessment at baseline and after a 2-year follow-up.

      Design

      Longitudinal study.

      Setting and Participants

      Convenience sample of community-dwelling people aged ≥60 years evaluated in an Irish university hospital.

      Methods

      Participants were evaluated at baseline (August 2007–May 2009) and after a 2-year follow-up. FoF was measured using the Modified Falls Efficacy Scale. Predictors of incident FoF at 2 years were investigated.

      Results

      At baseline, there were 563 participants (69% female, mean age 73 years). Among individuals that were not fearful at baseline, 105 (18.7%) developed FoF (incident FoF) after a median follow-up of 2.1 years. Individuals reporting incident FoF were older at baseline (P < .001), had worse performance in balance and physical function tests, and more frequently needed a walking aid (P < .001). Anxiety (P = .012) and depressive symptoms (P < .001) were more prevalent, as well as self-reported previous falls (P < .001). In multivariate analysis, older age, walking aid use, and a higher burden of depressive symptoms at baseline were predictors of incident FoF.

      Conclusions and Implications

      Almost a fifth of older adults using a walking aid and reporting depressive symptoms at baseline developed FoF after 2 years. These identifiable prodromal factors could help design FoF prevention strategies.

      Keywords

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