Maladaptive Fall Risk Appraisal and Falling in Community-Dwelling Adults Aged 60 and Older: Implications for Screening

Abstract

ABSTRACT Objectives We aimed to examine the characteristics of maladaptive fall risk appraisal (FRA), discrepancies between physical and perceived-fall risk, and their associations with falls. Methods Fall risk appraisal was determined using the full-tandem stand test as an objective measure and the Fall Efficacy Scale-International as a subjective measure, and 433 adults aged ≥60 years from Thailand were classified into four groups: irrational (low physical/high perceived risk), incongruent (high physical/low perceived risk), congruent (high physical/high perceived risk) and rational (low physical/low perceived risk) FRAs. Results Only 20.8% of adults aged ≥60 years had rational FRA. The rest of the participants had either irrational (57.3%) or incongruent (2.3%), or congruent (19.6%) FRAs. Approximately 74% of those with congruent FRA reported experiencing a fall last year, followed by incongruent (60%), irrational (41.1%), and rational FRAs (27.8%, p < .001). After covariates adjustment, participants with congruent FRA were 3.06 times more likely of falling than those with rational FRA (p = .011). Conclusions Maladaptive FRA is highly prevalent among adults aged ≥60. Identifying maladaptive FRA is essential for ensuring that adults aged ≥60 receiving early treatment associated with falls. Clinical implications Preventing a transition from rational to irrational, incongruent, and congruent fall risk appraisals is vital to prevent falls and mitigate this problematic health condition.