Abstract
Fear of falling (FOF) is expected to have effects on functional decline in the elderly. In this study, we examined over 2 years the effect of change in FOF on functional decline in community dwelling elderly. We conducted a secondary analysis using data from elderly women, 70 years of age and older, who participated in the Korean Longitudinal Study of Aging (KLoSA). Participants were divided into four categories according to change in FOF between the 2010 and 2012 surveys. Multiple logistic regression analysis was conducted regarding the effects of changes in FOF on functional decline after controlling for variables as known risk factors for functional decline. Rates of functional decline were highest in the “consistently having FOF” group, whereas they were lowest in the “consistently no FOF” group in both 2010 and 2012. Characteristics independently associated with functional decline were change in FOF, depressive symptoms, low frequency of meeting friends, and fear-induced activity avoidance. Longer exposure to FOF was associated with an increased risk of functional decline. FOF is an important health problem that deserves attention in its own right. Public health approaches for elderly persons should address early detection, prevention, and intervention programs for FOF.
Highlights
Fear of falling (FOF) has long been considered to be a result of psychological distress after a fall, called “post-fall syndrome” [1], and has been identified as a potentially modifiable threat to the autonomy and quality of life in older adults [2,3]
To assess the independent effect of FOF in functional decline, we considered the possible predictors of fear of falling or functional decline identified by the results of previous studies, including age, marital status and living arrangement, education, experiences of falling, number of chronic disease, cognitive function, sensory function, and disability in 2010 as covariates
We found that elderly persons with persistent FOF over the two surveys showed a higher risk of functional decline (OR = 3.43, 95% confidence intervals (CIs) = 2.15–5.47) than did those with a recent, 2-year exposure, to FOF (OR = 2.26, 95% CI = 1.36–3.75), and those having had FOF in the past (OR = 1.60, 95% 0.95–2.72)
Summary
Fear of falling (FOF) has long been considered to be a result of psychological distress after a fall, called “post-fall syndrome” [1], and has been identified as a potentially modifiable threat to the autonomy and quality of life in older adults [2,3]. FOF is prevalent in older adults who have not yet experienced a fall [4]. Regardless of any history of falls, the prevalence of FOF is reported to range between 20% and 85% among community dwelling older adults [4,5,6], with women being affected significantly more [3,4]. FOF is considered to contribute to a loss of independence or disability through the avoidance and restriction of activities [2,7,8]. Not all elderly with FOF avoid activities in daily life. FOF has a range of consequences, from increased caution during the performance of daily activities, which may be protective against falls, to a complete restriction of activities, which may be devastating [9]
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