Fear of Falling and Associated Variables in Community-Dwelling Elderly

Akulwar Isha S

doi:10.11648/j.ajap.20170606.13

Abstract

The purpose of this study was to determine the prevalence of fear of falling and its association with fall, avoidance of activity, balance deficits and risk of fall in community-dwelling older individuals. It was a cross-sectional study conducted in general community setting. Fifty community-dwelling elderly (mean age of 77.98 ± 2.83years), ambulatory, without any severe medical conditions participated in the study. Main outcome measures of the study were fear of falling (FOF), fall and activity avoidance assessed through an interview-based questionnaire; balance assessed using Berg Balance Scale (BBS); balance confidence assessed using Activities-specific Balance Confidence (ABC) scale. FOF and associated avoidance of activity was reported by 60% and 52% of the elderly respectively. In subjects reporting FOF, 76% were fallers, 44% being non-fallers. BBS score of the subjects reporting FOF was significantly lower (42.7 ± 10.12) than the subjects without FOF (53.65 ± 3.51). Also, the subjects with FOF had a score below 46, the cut-off point for predicting risk of falling. In subjects having FOF, 56.66% had low risk of falls and 43.33% had medium risk of falls whereas all the subjects with no fear of fall had low risk of falls. Subjects FOF reported a significantly lower balance confidence on ABC scale as compared to subjects without FOF. Thus, it is concluded that FOF and associated avoidance of activity are highly prevalent in the community-dwelling older people. FOF is significantly associated with fall/s, balance deficits with an increased fall risk, avoidance of activity and low balance confidence in doing activities of daily living. FOF can be considered as a significant health problem of equal importance to a fall. This study highlights the importance of identifying FOF and addressing factors related to it in the rehabilitation of the elderly.

Highlights

Ageing is a progressive functional decline, or a gradual deterioration of physiological function with age [1]
Variables distribution was tested using KolmogorovSmirnov test which exhibited significant departures from normality, and nonparametric tests were used for all analyses
Mann Whitney U test was used to examine the relationship of fear of falling (FOF) with Berg Balance Scale (BBS) score and Activities-specific Balance Confidence (ABC) scale score

Summary

Introduction

Ageing is a progressive functional decline, or a gradual deterioration of physiological function with age [1]. Falls are most commonly endured predicament by the elderly population in today’s community and are an important cause of morbidity and mortality in the elderly. Many older persons experience psychological difficulties directly related to the fall [2]. Among these psychological consequences are fear of falling (FOF), loss of self-efficacy, activity avoidance and loss of self-confidence. FOF can be considered as a significant health problem of equal importance to a fall and refers to the lack of selfconfidence that normal activities can be performed without falling [3]. FOF and associated avoidance of activity may lead to adverse consequences, like functional decline, restriction of social participation, decreased quality of life and increased risk of falling and institutionalization

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