Abstract
Objectives
Fear of falling (FOF) is common in older persons and related to negative outcomes.
This study aimed to investigate the relationship between 2 FOF measures: the Falls
Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction
(SQ-FAR). Factors associated with disagreement between the 2 measures were further
examined.
Design
Cross-sectional study.
Setting and Participants
Participants (N = 1359) were community-dwelling persons aged 65 to 70 years who were
enrolled in the Lausanne cohort 65+.
Methods
Data included demographic, functional, cognitive, affective, and health status. FOF
was measured with FES-I and the 3-level SQ-FAR (no FOF, FOF without activity restriction
(AR, FOF with AR). FES-I concern about falling was categorized as low (score 16–19),
moderate (score 20–27), and high (score 28–64).
Results
Weighted agreement between the FES-I and the SQ-FAR was 87.8% (Kappa = 0.57). Using
the FES-I as gold standard, the performance of SQ-FAR was good (specificity 86%; sensitivity
74%, negative predicting value 89%, positive predicting value 69%). Among participants
with moderate/high FOF according to FES-I, male sex (P = .011) and the absence of previous falls (P < .001) were associated with disagreement between the 2 tools. Among participants
with low FOF, female sex (P = .005), falls history (P < .001), and pre-frailty/frailty status (P = .050) were associated with disagreement.
Conclusions and Implications
The SQ-FAR has a moderate agreement with FES-I and might be used as a screening tool.
The results also may help design a step-by-step strategy to evaluate and address FOF
in the clinical setting.
Keywords
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Article info
Publication history
Published online: March 09, 2020
Footnotes
This work did not receive any funding from agencies in the public, commercial, or not-for-profit sectors. The Lc65 + study has been supported by University of Lausanne Hospital Center; University of Lausanne Department of Ambulatory Care and Community Medicine; Canton de Vaud Department of Public Health; City of Lausanne; Loterie Romande [research grant 2006–2008]; Lausanne University Faculty of Biology and Medicine [multidisciplinary research grant 2006]; Swiss National Foundation for Scientific Research [grant 3247B0-120795/1]; and Fondation Médecine Sociale et Préventive, Lausanne. The sponsors had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
The authors declare no conflicts of interest.
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
