Analysis of factors related to fear of falling in community-dwelling elderly patients with type 2 diabetes

Abstract

Objective To investigate the influence of fear of falling on clinical, functional, and gait variables in elderly patients with type 2 diabetes and to identify predictive factors for fear of falling in this population. Methods A total of 238 community-dwelling older persons with type 2 diabetes (aged 65 to 89 years) were divided into two groups according to Falls Efficacy Scale-International scores.Participants with a score<23 were assigned to the no-fear group (n=118) and those with a score≥23 were assigned to the fear group (n=120). Demographics, anthropometrics, number of diseases and medications, physical activity level, history of falls, frailty level, cognition, depressive symptoms, fasting glucose level, and disease progression were collected.Timed Up and Go test (TUG), five times sit-to-stand test (5-STS), and tests for grip strength and pace were run. Results Participants in the fear group were more frail and presented more depressive symptoms and worse performance in the TUG and 5-STS tests than in the no-fear group.The fear group also showed a slower pace, a shorter step length, a longer step time, and a longer swing time.Multivariate regression analysis revealed that the likelihood of having fear of falling increased by 1.32 times (OR: 1.32, 95%CI: 1.09-1.58) for every one-point increase in the Geriatric Depression Scale (GDS-15) score and by 1.35 times (OR: 1.35, 95%CI: 1.06-1.70) for every one-second increase in TUG. Conclusions The fear of falling in community-dwelling elderly patients with type 2 diabetes mellitus is associated with frailty, depressive symptoms, dynamic balance, functional mobility, and abnormal gait.Furthermore, both GDS-15 and TUG test can predict fear of falling in this population. Key words: Accidental falls; Fear; Diabetes mellitus, type 2