A - 17 Fear of Falling in Older Adults with mTBI

Abstract

Abstract Objective To evaluate the use of an assessment of fear of falling (i.e., Short Fall Efficacy Scale [SFES]) in the evaluation and management of mild traumatic brain injury (mTBI) in older adults. Methods Fifty-two older adults (40% male) aged 60–76 (66.44 ± 4.74) years were included in the study; 27 older adults diagnosed with mTBI within three months of injury (33.07 ± 18.86 days) and 25 age-group and sex-matched controls. All participants completed the SFES, Vestibular/Ocular-Motor Screening (VOMS), Post-Concussion Symptom Scale (PCSS), Generalized Anxiety Disorder- 7 Item (GAD-7), and Geriatric Depression Scale- 5 Item (GDS5). Statistical comparisons were performed using paired t-tests and Pearson correlations. Results There were no significant differences on demographic factors, with the exception of participants in the mTBI group being more likely to have a history of a sleep disorder (χ2 = 10.26, p = 0.001). T-tests revealed higher concern for falling on SFES and higher total symptoms on the VOMS, GAD-7, and PCSS (p < 0.01) in mTBI versus controls. Those with mTBI who sustained a fall, compared to other mechanisms of injury, did not differ in their report of fear of falling post-injury (p = 0.74). SFES scores were moderately correlated with VOMS total score (r = 0.40, p < 0.01), PCSS total score (r = 0.64, p < 0.01), GAD-7 (r = 0.65, p < 0.01), and GDS-5 (r = 0.60, p < 0.05). Conclusions Older adults with mTBI endorse greater fear of falling on the SFES and more symptoms on mTBI assessment tools relative to healthy controls. Future studies should include objective measures of balance to evaluate the relationship between fear of falling and postural stability.