Abstract
BackgroundFalls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care.MethodsThis study employed cross-sectional data from baseline measurements of a randomised controlled trial. 155 participants, aged 67+, with at least one fall in the previous year, from six Norwegian municipalities were included. Data on HRQOL (SF-36), physical function and fear of falling (FES-I) were collected in addition to demographical and other relevant background information. A multivariate regression model was applied.ResultsA higher score on FES-I, denoting increased fear of falling, was significantly associated with a lower score on almost all subscales of SF-36, denoting reduced HRQOL. Higher age was significantly associated with higher scores on physical function, general health, mental health and the mental component summary. This analysis adjusted for sex, education, living alone, being at risk of or malnourished, physical function like balance and walking speed, cognition and number of falls.ConclusionFear of falling is important for HRQOL in older fallers receiving home care. This association is independent of physical measures. Better physical function is significantly associated with higher physical HRQOL. Future research should address interventions that reduce fear of falling and increase HRQOL in this vulnerable population.Trial registrationClinicalTrials.gov. NCT02374307. First registration, 16 February 2015. First enrolment of participants, February 2016.
Highlights
Falls and injuries in older adults have significant consequences and costs, both personal and to society
The results show that a higher level of health-related quality of life (HRQOL), measured by social functioning (SF)-36, is substantially associated with lower fear of falling, measured by Falls Efficacy Scale International (FES-I)
The results show that a higher score on the subscale physical functioning (PF) is significantly associated with better gait speed (4MWT), improved balance (BBS) and better ability in instrumental activities of daily living (IADL)
Summary
Falls and injuries in older adults have significant consequences and costs, both personal and to society. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care. The rising costs of falls and associated injuries are of global concern [2], estimated at 1.5% of health care costs in European countries, both directly from the fall-related injuries and indirectly through loss of mobility, confidence and functional independence [3]. Costs for long-term care are expected to increase substantially in the future. These expenses can be greatly reduced if the older adults are in good health and are able to remain at home [1]. Home care services are important in maintaining independence, contributing to functional health status and improving the quality of life (QOL) among older adults [4].
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