Cross-Sectional and Longitudinal Risk Factors for Falls, Fear of Falling, and Falls Efficacy in a Cohort of Middle-Aged African Americans

Abstract

The purpose of this study is to cross-sectionally and longitudinally identify risk factors for falls, fear of falling, and falls efficacy in late-middle-aged African Americans. We performed in-home assessments on a probability sample of 998 African Americans and conducted two annual follow-up interviews. Multiple logistic regression modeled the associations with falls (any fall or injurious fall) during 2 years prior to the baseline interview, and baseline fear of falling and falls efficacy with 2-year prospective risks for falling and fear of falling. The most consistent association for all outcomes was depressive symptoms. Age was associated with increased risk of prior and prospective falls. Lower-body functional limitations were associated with prior falls, baseline fear of falling, and low falls efficacy, whereas low ability with one-leg stands prospectively predicted fear of falling. The greatest prospective risk for incident falls was having had a prior fall (odds ratio = 2.51), and the greatest prospective risk for fear of falling was having been afraid of falling at baseline (odds ratio = 8.14). Falls, fear of falling, and low falls efficacy are important issues for late-middle-aged as well as older persons. Interventions should focus on younger adults and attend especially to lower-body function and depressive symptoms as well as building self-efficacy for safe exercise, dealing with falls risks, and managing falls themselves.