Abstract

BackgroundFear of falling is a common and potentially disabling problem among older adults. However, little is known about this condition in older adults with diabetes mellitus. The aims of this study were to investigate the impact of the fear of falling on clinical, functional and gait variables in older women with type 2 diabetes and to identify which variables could predict the fear of falling in this population.MethodsNinety-nine community-dwelling older women with type 2 diabetes (aged 65 to 89 years) were stratified in two groups based on their Falls Efficacy Scale-International score. Participants with a score < 23 were assigned to the group without the fear of falling (n = 50) and those with a score ≥ 23 were assigned to the group with the fear of falling (n = 49). Clinical data included demographics, anthropometrics, number of diseases and medications, physical activity level, fall history, frailty level, cognition, depressive symptoms, fasting glucose level and disease duration. Functional measures included the Timed Up and Go test (TUG), the five times sit-to-stand test (5-STS) and handgrip strength. Gait parameters were obtained using the GAITRite® system.ResultsParticipants with a fear of falling were frailer and presented more depressive symptoms and worse performance on the TUG and 5-STS tests compared with those without a fear of falling. The group with the fear of falling also walked with a lower velocity, cadence and step length and increased step time and swing time variability. The multivariate regression analysis showed that the likelihood of having a fear of falling increased 1.34 times (OR 1.34, 95 % CI 1.11–1.61) for a one-point increase in the Geriatric Depression Scale (GDS-15) score and 1.36 times (OR 1.36, 95 % CI 1.07–1.73) for each second of increase in the TUG performance.ConclusionsThe fear of falling in community-dwelling older women with type 2 diabetes mellitus is associated with frailty, depressive symptoms and dynamic balance, functional mobility and gait deficits. Furthermore, both the GDS-15 and the TUG test predict a fear of falling in this population. Therefore, these instruments should be considered during the assessment of diabetic older women with fear of falling.

Highlights

  • Fear of falling is a common and potentially disabling problem among older adults

  • The group with the fear of falling had a significantly higher prevalence of frail individuals, demonstrated more depressive symptoms and exhibited worse performance on the Timed Up and Go (TUG) and five times sit-to-stand test (5-STS) tests compared to the group without the fear of falling

  • The current study revealed that the fear of falling in community-dwelling older women with type 2 diabetes mellitus (DM2) without neuropathic symptoms is associated with a higher frailty

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Summary

Introduction

Little is known about this condition in older adults with diabetes mellitus. According to the International Diabetes Federation, 134.6 million people (18.6 %) aged between 60 and 79 years were estimated to have diabetes in 2013 [2]. This disease has detrimental effect on multiple organ systems that when combined with the natural aging process and other agerelated conditions leads to poorer outcomes compared to those without diabetes [2]. Previous longitudinal study demonstrated that type 2 diabetes is associated with an accelerated loss of leg muscle strength and quality in community-dwelling older adults [6]

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