Abstract
Objectives
Fear of falling (FOF) is common in older people and is related to negative outcomes.
This study aimed to investigate whether 2 different instruments, the Falls Efficacy
Scale–International (FES-I) and the single question on FOF and activity restriction
(SQ-FAR), were associated with incident disability at 3 years.
Design
Prospective observational study.
Setting and Participants
Participants (n = 1219, 57.4% women) were disability-free community-dwelling persons
enrolled in the Lausanne cohort 65+, aged 66 to 71 years, in 2005.
Measures
Baseline covariates included demographic, cognitive, affective, and health status.
Basic activities of daily living (BADL) assessment was recorded annually from a self-administered
questionnaire. Disability outcome was defined as reporting difficulty or help needed
in ≥1 of 5 BADL in ≥2 consecutive years, or being institutionalized during follow-up.
Results
At 3 years, disability was reported by 77 participants (6.3%). Reporting the highest
level of fear at FES-I [adjusted odds ratio (aOR) 5.14, 95% confidence interval (CI)
1.82-14.55, P = .002] or “FOF with activity restriction” with SQ-FAR (aOR 3.23, 95% CI 1.29-8.08,
P = .012) were both associated with increased odds of disability even after adjusting
for covariates. The FES-I model explained incident disability slightly better than
the SQ-FAR one [Bayesian information criterion (BIC) values of 466.70 and 469.43,
respectively].
Conclusions and Implications
High FOF and related activity restriction, assessed with FES-I and SQ-FAR, are associated
with incident disability in young-old community-dwelling people. The SQ-FAR is suitable
as a screening tool to proactively detect a potentially reversible risk factor for
disability. Using the FES-I may serve additional clinical purposes, such as FOF characterization
and management.
Keywords
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Article info
Publication history
Published online: July 19, 2020
Footnotes
Funding: 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 Centre; 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.
