Abstract
BackgroundAn understanding of capacity for physical activity in obese populations should help guide interventions to promote physical activity. Fear of falling is a phenomenon reported in the elderly, which is associated with reduced mobility and lower physical activity levels. However, although falls are reportedly common in obese adults, fear of falling and its relationship with activity has not been investigated in younger obese populations.MethodsIn a cross-sectional study, fear of falling was measured in 63 women aged 18 to 49 years, with mean BMI 42.1 kg/m2 (SD 10.3) using the Modified Falls Efficacy (MFES), the Consequences of Falling (COF) and the Modified Survey of Activities and Fear of Falling in the Elderly (MSAFFE) scales. The choice of scales was informed by prior qualitative interviews with obese younger women. Physical activity levels were measured at the same time using the International Physical Activity Questionnaire. The mean score for fear of falling scales, with 95% confidence intervals, were estimated. Chi-square tests and t-tests were used to explore differences in age, body mass index and fear of falling scores between fallers and non-fallers. For each fear of falling scale, binomial logistic regression was used to explore its relationship with physical activity.ResultsMean scores suggested high levels of fear of falling: MFES [mean 7.7 (SD 2.7); median 8.5]; COF [mean 31.3 (SD 9.4)]; MSAFFE [mean 25.9 (SD 8.7); median 23]. Scores were significantly worse in fallers (n = 42) compared to non-fallers (n = 21). MFES and MSAFFE were independently associated with lower levels of physical activity [odds ratio = 0.65, 95% Cl 0.44 to 0.96 and odds ratio = 1.14, 95% CI 1.01 to 1.28 respectively], when adjusted for age, BMI and depression.ConclusionsThis study confirms that fear of falling is present in obese women under 50 years of age. It suggests that it is associated with low levels of physical activity. These novel findings warrant further research to understand capacity for physical and incidental activity in obese adults in both genders and suggest innovative interventions to promote lifestyle changes and/or consideration of falls prevention in this population.
Highlights
An understanding of capacity for physical activity in obese populations should help guide interventions to promote physical activity
We explored whether greater fear of falling was associated with lower levels of physical activity in this population
The questionnaire included questions on the frequency of falls in the last 12 months; activity levels measured using the short form International Physical Activity Questionnaire (SF-IPAQ) [13]; mood measured using the subscales of the Hospital Anxiety and Depression Scale (HADS) [14], and three questionnaires covering different aspects of fear of falling
Summary
An understanding of capacity for physical activity in obese populations should help guide interventions to promote physical activity. Fear of falling is a phenomenon reported in the elderly, which is associated with reduced mobility and lower physical activity levels. Obese adults are more likely to report falls and balance problems [4,5,6] These concerns are seen in the elderly with ‘fear of falling’, a phenomenon that has been inconsistently defined but encompasses a number of related concepts, such as, lack of confidence in undertaking activities because of concerns about falling, activity avoidance because of concerns about falling and concerns about the consequences of falling [7]. We explored whether greater fear of falling was associated with lower levels of physical activity in this population
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