Fear Of Falling Research Articles

Relationship Between Severity of Multiple Sclerosis and Fear of Falling Mediated by Cognitive and Physical Factors

Background & Aims: Multiple sclerosis (MS) patients are exposed to various health threats, including fear of falling (FOF), which restricts their daily life activities and cause isolationism and lower social participation. The present study aimed to investigate the relationship between the severity of MS and FOF through the mediating role of cognitive and physical factors in patients with MS. Materials and Methods: This was a correlational study based on path analysis. The statistical population consisted of all patients with MS who visited the neurology centers of hospitals in Sari, Iran, 200 of whom were selected as the sample using convenience sampling. The research instruments included the Falls Efficacy Scale-International (FES-I), MS Severity Scale, Cognitive Factors Questionnaire, and the MOS 36-item Short-Form Health Survey (SF-36). Results: The results indicated that there was a negative and significant relationship between FOF and cognitive and physical factors and also a positive and significant relationship between FOF and the severity of MS (P<0.01). In addition, the results corroborated the negative and significant relationship between the severity of MS and physical factors (P<0.01). However, the direct relationship between the severity of MS and cognitive factors were excluded from the model because it was not established. The study findings confirmed the relationship between FOF and the severity of MS mediated by cognitive and physical factors (P<0.001). Conclusion: According to the results FOF was found to be much higher among patients with higher MS severity. The severity of MS had a positive relationship with FOF in the patients. Moreover, cognitive and physical factors had a mediating role in the relationship between the severity of MS and FOF.

The association between depressive symptoms with fear of falling and cognitive decline in older adults in the Korean community: An analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006–2020

ObjectivesThis study aimed to investigate the effects of fear of falling (FOF) on cognitive decline in older adults in the Korean community, depending on the presence of accompanying depressive symptoms. MethodsA total of 6263 individuals were included in the final analysis. Based on their baseline evaluation results for depressive symptoms and FOF, the subjects were divided into four groups: “normal control” (NC, n = 3783), “depression only” (Dep-only, n = 291), “fear of falling only” (FOF-only, n = 1755), and “depression with fear of falling” (Dep-FOF, n = 434). Cognitive decline was defined as a loss of more than three points in the K-MMSE score in participants with at least two years of follow-up. We examined the association between FOF accompanied by depressive symptoms and cognitive decline using a multivariate Cox proportional hazard model. ResultsCognitive decline occurred in 76.3%, 68.5%, 63.9%, and 56.4% of the Dep-FOF, FOF-only, Dep-only, and NC groups, respectively. Our findings suggest that individuals with FOF do not always have cognitive decline (HR = 1.03, 95% CI = 0.95–1.12, P = 0.43) compared to individuals without FOF. Furthermore, depressive symptoms with FOF are associated with a higher risk of cognitive decline (HR = 1.23, 95% CI = 1.08–1.41, P = 0.002) in community-dwelling older adults in Korea. ConclusionHealthcare providers should be attentive to community-dwelling older adults who experience both depressive symptoms and FOF because our findings suggest that this unique combination increases the risk of cognitive decline.

Demographics moderated the association of symptom burden with falls and fall-related outcomes

ObjectivesTo examine whether (1) prior-year symptom burden predicted later-year falls and fall-related outcomes and (2) demographics moderated the longitudinal effects of symptom burden on falls and fall-related outcomes among community-dwelling older adults. MethodsWe used 2011–2018 National Health and Aging Trends Study data that included 9,060 community-dwelling older adults (contributed 34,327 observations). Falls and fall-related outcomes included self-reported falls, multiple falls, fear of falling (FOF), and FOF limiting activity. Symptom burden was defined as the presence of pain, insomnia, breathing difficulty, depressive symptoms, anxiety, and fatigue, and calculated the number of symptoms (range from 0 to 6). Binomial logistic regression was used to examine the associations between symptom burden and falls and fall-related outcomes and the moderation effects of demographic factors. ResultsThe majority of the sample were aged between 65 and 79 years old (57.7%), non-Hispanic White (70.5%), and female (58.4%). Each additional symptom was associated with an increased risk of falls (Adjusted Odds Ratio [AOR]: 1.13, 95% CI: 1.10–1.15), multiple falls (AOR: 1.15, 95% CI: 1.12–1.18), FOF (AOR: 1.20, 95% CI: 1.18–1.23), and FOF limiting activity (AOR: 1.24, 95% CI: 1.20–1.28). Age, race/ethnicity, education, and living arrangement statistically significantly moderated the relationships between symptom burden and falls and fall-related outcomes. ConclusionsSymptom burden predicted falls, multiple falls, FOF and FOF limiting activity, and demographics may differentially modify this risk. Individually tailored symptom assessment and management plans should be incorporated into fall risk assessment and interventions for community-dwelling older adults living.

Falls and fear of falling: an underestimated sequelae in Behçet’s disease

BackgroundBehçet’s disease (BD) is an inflammatory autoimmune disorder. Balance is a multifactorial process that is ultimately affected in BD leading to frequent falls. Fear of falling (FOF) is a significant risk factor for falls. The study aimed to evaluate the risk of falls and FOF in BD and their relations to disease activity and damage.ResultsIn BD patients, the history of falls and FOF was 65.6% and 48.4%, respectively. The Berg Balance Scale was low in BD patients (P = 0.003). Falls and fear of falling showed significant relations with the disease activity and disease damage (P < 0.001). There were significant relations between fallers with arthritis (P = 0.003) and active neurological affection (P = 0.004) than non-fallers. A higher balance scale significantly independently decreases the risk of falls (AOR = 0.79, P = 0.005) and FOF (AOR = 0.904, P = 0.039); however, high BD damage and disease duration increase the risk with AOR = 2.364, P = 0.009 and AOR = 0.769, P = 0.088, respectively.ConclusionArthritis and active neurological affection are significantly related to falls and FOF; also, FOF is significantly related to active uveitis. Impaired balance, long disease duration, and high disease damage score are significant risk factors for falls and FOF in BD.

Cognitive status and sleep quality can explain the fear of falling and fall history in people with Parkinson's disease.

Fear of falling (FOF) is highly prevalent in people with Parkinson's disease (PwPD) and contributes to high fall risk. Studies reporting on the relationship between falls, FOF, and non-motor factors such as cognitive function and sleep quality in Parkinson's disease are limited. This study aimed to investigate (1) the relationship of cognitive function and sleep quality with FOF, and history of falls in PwPD; (2) differences in cognitive function and sleep quality between Parkinson's disease fallers and non-fallers; and (3) a cut-off score for cognitive function and sleep quality to discriminate Parkinson's disease fallers from non-fallers. Fifty PwPD were assessed for FOF [Falls Efficacy Scale-International (FES-I)], cognition [Montréal Cognitive Assessment (MOCA)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and falls history. The MOCA is significantly associated with FES-I scores ( R2 = 0.429, P < 0.0001). Both MOCA ( P = 0.012) and PSQI ( P = 0.027) were associated with falls history even after adjusting for confounding factors (age, sex, L-dopa use, Parkinson's disease severity). Both MOCA and PSQI scores were able to distinguish fallers from non-fallers with cut-off scores of 15.5 and 7.5, respectively. Although our findings revealed that both cognitive function and sleep quality are important factors influencing falls and FOF in PwPD, it remains to be determined if addressing cognitive impairments and poor sleep quality may favorably impact balance before integrating such screenings into fall prevention programs.

The association between physical activity and fear of falling among community-dwelling older women in China: the mediating role of physical fitness.

This study aimed to explore the association between physical activity (PA) and fear of falling (FOF) and to determine whether this relationship was mediated by physical fitness (PF) in community-dwelling older women. For this cross-sectional study, a total of 1,108 older women were recruited. Moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) were objectively measured by accelerometers. Physical fitness indicators including body mass index (BMI), forced vital capacity, choice reaction time, grip strength, sit and reach, and five times sit-to-stand were measured. FOF was evaluated by the Chinese version of the activities-specific balance confidence scale. A stepwise linear regression model analysis was used for mediation analysis, and bootstrap analysis was used to verify the mediation effects. The Pearson correlation coefficient results suggested that MVPA was significantly and negatively correlated with FOF while LPA was not correlated with FOF. Logistic regression analysis suggested a significant association between MVPA, BMI, forced vital capacity, choice reaction time, sit and reach, grip strength, five times sit-to-stand, and FOF. The mediation analysis showed a negative relationship between MVPA and FOF. BMI completely mediated the relationship between MVPA and FOF while sit and reach, five times sit-to-stand, and forced vital capacity partially mediated the relationship between MVPA and FOF. Accumulation of more daily MVPA was associated with reducing the odds of FOF in community-dwelling older women. PF indicators fully or partially mediate the relationship between MVPA and FOF. Therefore, more intervention efforts should focus on the promotion of MVPA to improve PF and thus reduce FOF among older women.

Fear of Falling as a Behavioral Symptom in Neurocognitive Impaired Patients: Evidence from an Underrepresented Population.

Fear of falling (FoF) is a condition associated with falls, multi-morbidity, and functional impairment. To date it remains unknow which clinical, somatic, socio-demographic, behavioral, and emotional factors are associated with FoF and how these factors interact in people with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Identify the association of FoF with clinical, socio-demographic, and neuropsychiatric factors in patients with AD and bvFTD. We evaluated 98 participants, 58 with AD and 40 with bvFTD at mild or moderate stages and assess FoF using the Falls Efficacy Scale-International. Additionally, we analyzed cognitive, physical performance variables, functional impairment, and affective and behavioral symptoms associated with FoF using standardized scales and a regression model analysis. The prevalence of FoF in AD and bvFTD was 51% and 40%, respectively. In the AD group, physical performance [F (3, 53) = 4.318, p = 0.009], the behavioral symptoms model [F (19, 38) = 3.314, p = 0.001], and the anxiety model [F (1, 56) = 13.4, p≤0.01] showed statistically significant values. In addition, the presence of hallucinations assessed with the Neuropsychiatric Inventory and social behavior assessed with the Mild Behavioral Impairment Checklist were significant. In contrast, in the bvFTD group, a homologous group of models was evaluated but we did not find any significant results. FoF in people with AD was related to physical performance, neuropsychiatric symptoms such as apathy and hallucinations, and affective symptoms such as anxiety. However, this pattern was not seen in the bvFTD group, and therefore further studies are required.

Longitudinal Relationship between Mobility Device Use, Falls and Fear of Falling (FOF) Differed by Frailty Status among Community-Dwelling Older Adults.

This study examined the longitudinal relationship between mobility device use, falls and fear of falling (FOF) among community-dwelling older adults by frailty status over a one-year follow-up. A longitudinal cohort study. Communities in the United States. Community-dwelling older adults from the National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the United States (N=5,896). Based on yes or no response to the corresponding items for the variables, fall-related outcomes were determined separately including falls and FOF. Falls were assessed by asking participants whether they had a fall and if they had fallen down more than one time. FOF was measured by asking participants whether they worried about falling and if this worry ever limited activities. Mobility device use was determined by asking whether participants used any type of mobility devices and the number of devices used, including cane, walker, wheelchair and scooter. Frailty was assessed using the frailty phenotype. Multinomial logistic regression models were conducted to examine the association between mobility device use and fall-related outcomes among older adults by frailty status. At Year 1, 28.6% of participants reported using mobility devices. Among robust participants, using one mobility device had 3.58 times higher risks of FOF with fear-related activity restriction (FAR) than non-device users (95% CI: 1.10-11.65). Cane-only robust users had 5.94 and 2.18 times higher risks of FOF with and without FAR (95% CI: 1.80-19.57; 95% CI: 1.12-4.22) than non-device users. Among pre-frail participants, using one mobility device was associated with recurrent falls and FOF with FAR (RRR=2.02, 95% CI: 1.30-3.14; RRR=2.13, 95% CI: 1.25-3.63). Using ≥2 devices was associated with one fall (RRR=2.08, 95% CI: 1.30-3.33), recurrent falls (RRR=2.92, 95% CI: 1.62-5.25) and FOF with FAR (RRR=2.84, 95% CI: 1.34-6.02). Pre-frail cane-only users were more likely to have one fall (RRR=1.57, 95% CI: 1.06-2.32), recurrent falls (RRR=2.36, 95% CI: 1.48-3.77) and FOF with FAR (RRR=2.08, 95% CI: 1.12-3.87) than non-device users. The number of mobility device used and the use of canes failed to be significantly associated with fall-related outcomes among frail participants. The number of mobility devices used and the only use of canes were associated with fall-related outcomes among robust and pre-frail individuals. Further research is needed to develop targeted strategies for preventing falls and FOF among older adults with mobility device use, particularly for those in the early stages of frailty.

Falls, fear of falling, and related factors in patients with diabetic foot disease

BackgroundFalls and fear of falling (FOF) are common in patients with diabetic foot disease (DFD). PurposeTo understand the relationship between falls, FOF, and related factors in patients with DFD. MethodWe recruited 70 patients being treated for DFD at two hospitals in Korea. A structured questionnaire was used in investigating fall experience, FOF, and related factors. ResultsAmong the participants, 42.8 % fell in the past year, and FOF was reported in 57.1 %. Rates of “no caregiver,” “DFD duration (>1 year),” and “burning pain” were higher in fallers than non-fallers. The rates of “older adults (≥65 years of age),” “unemployed,” “not using assistive devices,” “visual impairment,” and “hearing impairment” were higher in patients with FOF than in those without FOF. However, the level of balance confidence was lower in patients with FOF. ConclusionsThe fall experience of patients with DFD was associated with the presence of their caregiver, disease-related factors, and foot pain symptoms, while FOF was related to age and fall-related factors.

Fear of falling as a mediator in the association between social frailty and health-related quality of life in community-dwelling older adults

BackgroundSocial frailty is associated with Fear of Falling (FoF) and health-related quality of life (HrQoL). However, how social frailty simultaneously influences FoF and HrQoL remains unclear. The study aims to understand the links between social frailty, FoF, and HrQoL in older adults and the mediating role of FoF in the relations between social frailty and HrQoL.MethodsIn this cross-sectional survey, 1,933 community-dwelling older adults from Changhua County, Taiwan, were interviewed using a self-administrated questionnaire. In total, 1,251 participants with complete data were included for analysis. Data were analyzed using the SPSS PROCESS macro. A simple mediation was employed using social frailty as the independent variable, FoF as the mediator variable, and HrQoL as the outcome variable.ResultsSocial frailty was associated with HrQoL and indirectly with HrQoL through FoF, and FoF was directly associated with HrQoL. Of the 5-item social frailty index, “going out less frequently” was correlated with HrQoL and indirectly with HrQoL through FoF. Individuals who felt unhelpful toward family or friends had the worst physical HrQoL and did not talk to someone daily had the most negative influence on mental HrQoL.ConclusionsSocial frailty can directly and indirectly, through FoF decrease HrQoL. It also emphasizes the importance of social connectivity in reducing the risk of falls. This study points to the need for social connectivity and fall prevention programs as essential components of strategies to enhance the health and well-being of community-dwelling older adults.

The Relationship Between Fear of Falling and Physical Activity among Older Adults

Introduction: Physical activity (PA) improves balance, walking, and muscle strength and reduces the prevalence of falls among the elderly. Fear of falling (FOF) is the most common fear among older adults and a major health problem among them. Therefore, this study was conducted to determine the relationship between FOF and PA among older adults in Iran. Methods: This cross-sectional study was conducted on 687 elderly people aged ≥ 60 years in Yazd province, Iran using cluster sampling method. The data collection tools were The Falls Efficacy Scale International and the Physical Activity Scale for the Elderly. The data were analyzed by describing frequency distribution, Mann-Whitney, Spearman correlation tests and Hierarchical regression under SPSS software. Results: The mean score of FOF and PA were 27.08 ± 12.30 (range 16-64) and 86.87 ± 79.15 (range 0-494), respectively. There was an inverse significant correlation between PA and FOF(r = -0.304) and with increasing age, PA of the elderly decreases, and the FOF increases. Demographic variables (age, gender, living status, and retirement status) which were entered into the model in the first stage, predicted 10.9 % of the variance of PA (p &lt; 0.001). In step 2, chronic diseases predicted 3.5 % which was statistically significant and in step 3, FOF also significantly predicted 2.8% of the variance of PA (p &lt; 0.001). Conclusion: The level of PA among older adults is very low, so it is very important to know the factors influencing that, to take action to prevent the occurrence of these factors, and also to eliminate them. Considering that demographic variables and FOF can predict changes in PA, therefore, it is possible to improve the PA of older adults by performing appropriate interventions on these issues.

A systematic review of fear of falling and related constructs after hip fracture: prevalence, measurement, associations with physical function, and interventions

BackgroundHip fracture is a common and debilitating injury amongst older adults. Fear of falling (FoF) and related constructs (balance confidence and falls efficacy) may impede rehabilitation after hip fracture. An updated systematic review to synthesize existing literature on FoF after hip fracture is needed. This review focussed on four research questions: In the hip fracture population: (1) What is the prevalence of FoF?; (2) What FoF assessment tools are validated? (3) What is the relationship between FoF and physical function?; (4) What interventions are effective for reducing FoF?MethodsA systematic search was undertaken in EBSCO Health, Scopus and PsychINFO in January 2021 (and updated December 2022) for articles on FoF after hip fracture. Data in relation to each research question was extracted and analysed. The quality of the studies was appraised using the ‘Risk of Bias Tool for Prevalence Studies’, ‘COSMIN Risk of Bias checklist for Patient-reported outcome measures’, modified version of the ‘Appraisal Tool for Cross-sectional studies’, and the ‘Cochrane Risk of Bias 2’ tools for each research question, respectively.Results36 studies (37 articles) with 5099 participants were included (mean age 80.2 years and average 78% female). Prevalence rates for FoF after hip fracture ranged between 22.5% and 100%, and prevalence tended to decrease as time progressed post hip fracture. The ‘Falls Efficacy Scale – International’ (FES-I) and ‘Fear of Falling Questionnaire – Revised’ (FFQ-R) were found to be reliable, internally consistent, and valid tools in hip fracture patients. FoF after hip fracture was consistently associated with measures of physical function including balance, gait speed, composite physical performance measures and self-reported function. Ten of 14 intervention studies were considered high risk of bias. Exercise-based interventions with or without a psychological component were not effective in reducing FoF after hip fracture compared to a control condition.ConclusionFoF is prevalent after hip fracture and is consistently associated with poorer physical function. Only two instruments (FES-I and FFQ-R) have been validated for measuring FoF in the hip fracture population. However, there remains a need for larger, higher quality randomised controlled trials targeting FoF after hip fracture in order to guide clinical practice.Trial registrationPROSPERO registration: CRD42020221836.

Fear of falling is associated with gait parameters during obstacle avoidance with different physical characteristics in older adults

BACKGROUND: Fear of falling (FOF) is related to worse locomotor performance, is a predictor of decline in functionality, and predisposes falls in older adults. It is necessary to investigate how FOF influences locomotor parameters during walking and in obstacle avoidance in older adults. AIM: To investigate the relationship between FOF and the locomotor variables during walking through and obstacle avoidance with different physical characteristics. METHOD: 22 older adults participated in this study and were invited to perform three tasks: 1) Walking Through; 2) Walking with a solid obstacle and 3) Walking with a fragile obstacle. RESULTS: Correlations were found between FOF and following variables: 1) Walking Through: step velocity (r=-0.640, p=0.003), width (r=0.641, p=0.003), double support time (r=0.523, p=0.022); 2) Solid obstacle: step velocity (r=-0.666, p=0.002), length (r=-0.758, p&lt;0.001), foot-obstacle horizontal distance (r=-0.479, p=0.038), right stride velocity (r=-0.534, p=0.019), length (r=-0.522, p=0.022), left stride velocity (r=-0.551, p=0.014), left stride duration (r=0.561, p=0.012); 3) Fragilid obstacle: step velocity (r=-0.629, p=0.004), length (r=-0.556, p=0.014), foot-obstacle distance (r=-0.540, p=0.017), obstacle-foot distance (r=-0.492, p=0.032), right stride velocity (r=-0.583, p=0.009), length (r=-0.498, p=0.030), left stride velocity (r=-0.574, p=0.010), length (r=-0.462, p=0.047), width (r=-0.514, p=0.024), right stride duration (r=0.479, p=0.038), left stride duration (r=0.646, p=0.003). CONCLUSION: The characteristics of the obstacle did not influence the older adults FOF during walking through and obstacle avoidance. Although they adopt predictive and reactive compensatory adaptations in an attempt to make the task safer, these adaptations actually make the task more dangerous and increase the risk of stumbling and falling.

Overlapping status of frailty and fear of falling: an elevated risk of incident disability in community-dwelling older adults.

Although overlapping frailty and fear of falling (FoF) are likely to increase with population aging, the combined effect of frailty and FoF on incident disability is not yet well understood. The purpose of this study is to examine whether frailty combined with FoF increased the risk of incident disability in older adults. Our secondary purpose was to clarify the synergistic effect of frailty and FoF on incident disability. This is a prospective study. Participants were 9372 older adults (mean age 73.5years). Frailty status was assessed using the Japanese Cardiovascular Health Study index, and FoF was measured using two closed questions. Incident disability was prospectively monitored by their long-term care insurance records. During the follow-up period (mean duration 23.4months), 487 (5.2%) participants developed disability. The proportion of incident disability linearly increased according to FoF level regardless of baseline frailty status. Frail participants with FoF had a higher risk of incident disability than those with frailty only or neither (adjusted hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.95-3.54). Frailty in combination with excessive FoF further increased the risk of incident disability (adjusted HR 4.30, 95% CI 2.56-7.23) although no synergistic effect was observed (relative excessive risk due to interaction 1.69, 95% CI - 0.55, 3.93). The overlapping status of frailty and FoF, especially excessive FoF, increases the risk of incident disability in older adults.

Neighborhood safety, fall indices, physical activity level and social participation restrictions from a population of community-dwelling older adults in Nsukka, Enugu State, Nigeria

BackgroundRestriction in physical activity (PA) and social participation restriction (PR) can be heightened in the presence of fear of fall (FOF), fall experience, and perceived unsafe neighborhood, particularly among older adults. Despite the enormous benefits of social participation and physical activity, many older adults remain vulnerable to participation restriction and this probably accounts for a significant proportion of health challenges for older adults.ObjectiveThis study investigated the relationship between neighborhood safety (NS), fall indices, physical activity, and social participation restriction among older adults from selected communities in Nsukka, Enugu state, Nigeria.MethodsThis was a cross-sectional survey of 170 recruited via consecutive non-probability sampling techniques. Socio-demographic variables, co-morbidities, and fall prevalence were obtained using a self-administered questionnaire. The study instruments include the PA neighborhood environment scale – Nigeria (PANES-N), PA scale for elderly (PASE), Participation scale (PS), Modified fall efficacy scale (MFES), and Fall risk assessment tool (FRAT) and fall indices.Statistical analysisDescriptive statistics of mean and standard deviations, frequency counts, and percentages were used to analyze the socio-demographic variables, and Inferential statistics of Spearman rank order correlation were used to determine the relationship among the neighborhood safety, fall indices, physical activity level, and participation restrictions.ResultsPR has a negative relationship with NS (r = -0.19, p- 0.01), and fall efficacy (r = -0.52, p- 0.001). However, PR has a positive relationship with fall risk (r = 0.36, p = 0.001).ConclusionParticipation restriction is negatively correlated with neighborhood safety, fall efficacy, and PA. The PR has a positive relationship with fall risk (FR).

Risk factors for falls and fear of falling among older patients with cancer.

e24032 Background: Cancer is a disease of the elderly with more than 60% of all cancers diagnosed in adults age 60 or older. Falls pose a substantial risk for older cancer patients leading to hip fractures, traumatic brain injury, and are the leading cause of injury-related hospitalizations in persons aged 60 and older. This risk is due to aging changes compounded by the effect of cancer and cancer therapy. This report aims at understanding risk factors for falls and the perception of fear of falling (FOF) among older patients with cancer. Methods: As a single-site, retrospective cohort study, data was derived from 249 geriatric oncology patients from Senior Adult Oncology Center at Jefferson Health. The primary endpoints are the number of falls in the preceding 12 months and FOF as part of a self-reported fall screening. Multivariate logistic regression model was used to identify the independent risks factors by including patients’ age, sex, race/ethnicity, BMI, polypharmacy, cancer types, ECOG scores, Timed up and go (TUG) test, CARG toxicity scores, Mini-Cog, frailty status and depressive symptom for each endpoint separately. Results: Majorities were White (62.1%) and female (57.2%) with a mean ages of 78.1 (SD = 8.7). The most common cancers diagnosed were hematologic malignancy (34.1%), gastrointestinal (23.4 %) and breast cancer (16.1%). 26.1% experienced one or more falls in the past 12 months and 28.9% were worried about falling. Average CARG score is 10.1 (SD = 3.8). 50.4% had an abnormal TUG tests and 23.6% had an abnormal Mini-Cog. In the multivariate logistic regression, CARG score (OR = 1.46 95% CI = 1.30 - 1.65, p = 0.000) was associated with falls in the past 12 months after adjusting for confounders. Further, both abnormal TUG (OR = 4.63 95% CI = 2.12-10.13 p = 0.000) and increased CARG score (OR = 1.17 95% CI = 1.05-1.31 p = 0.005) were associated with FOF. Conclusions: Falls and FOF are common among older cancer patients in our cohort. As the CARG toxicity score found as a major predictor for prior falls, our findings suggest the importance of future toxicity risk-tailored interventions which could potentially lead to the prevention of further falls. We also found that the TUG test and CARG were associated with FOF, which might diminish older cancer patient’s confidence in participating in daily activities. Future research is needed to investigate causal relationship among comprehensive risk factors and the efficacy of tailored interventions.

Levels of Accelerometer-Based Physical Activity in Older Adults With a Mismatch Between Physiological Fall Risk and Fear of Falling.

We examined the associations between levels of accelerometer-based physical activity and the mismatch of physiological fall risk and fear of falling (FOF) in community-dwelling older adults. We assessed 123 participants who received 7-day wrist-worn accelerometry. Physiological fall risk was assessed using the portable BTrackS™ balance system and FOF was assessed using a short version of the Falls Efficacy Scale-International. Participants were categorized into four groups: rational (low FOF/normal balance), irrational (high FOF/normal balance), incongruent (low FOF/poor balance), and congruent (high FOF/poor balance). One third of older adults had a mismatch between their FOF and actual fall risk. Accelerometer-based moderate to vigorous physical activity (MVPA) was significantly different in the irrational group compared to the rational group (p = 0.023) and the congruent group compared to the rational group (p = 0.032). Encouraging older adults to improve MVPA may prevent them from shifting from rational to irrational or congruent groups, thereby reducing the risk of injurious falls. [Journal of Gerontological Nursing, 49(6), 41-49.].

Clinical correlates of Fear of Falling in Progressive Supranuclear Palsy and Multiple System Atrophy.

Clinical correlates of fear of falling (FoF) are scarcely studied in patients with Progressive Supranuclear Palsy (PSP) and Multiple System Atrophy (MSA). To evaluate the clinical correlates of FoF in PSP and MSA. A cross-sectional study with motor , cognitive and psychiatric assessment and longitudinal evaluation of falls and FoF at 6-month follow-up. Twenty-one patients with PSP-P, 22 with MSA (13 MSA-P and 9 MSA-C) and 22 healthy controls were evaluated. 76.2% of patients with PSP and 86.4%of patients with MSA had FoF regardless of falls. Berg Balance Scale (p<0.001), Tinetti Mobility Test (p<0.01), Beck Anxiety Inventory (p=0.001) and Beck Depression Inventory-II (p=0.01) correlated with FoF in patients with PSP and MSA, whereas Timed up and Go test (p=0.01) and Starkstein's Apathy Scale only in MSA (p=0.04). Mobility, balance and gait performance as well as anxiety and depression in PSP and MSA, and apathy in MSA were determinants of FoF. These findings underline the importance of a multidisciplinary approach to FoF in neurodegenerative atypical parkinsonism.

Overcoming waves of helplessness: The meaning of experiencing fear of falling

Fear of falling (FOF) is prevalent among older adults. While the phenomenon has been conceptually defined and the factors associated with FOF are evident in the nursing literature, the deeply personal experience of this fear from the perspective of older adults is often overlooked. The aim of this study was to explore the meaning of experiencing FOF among older adults (N = 4). Each participant was interviewed twice using van Manen's interpretive phenomenological methodology. Four major interpretive themes emerged: Loss of Self, Part of my Existence, Remaining Safe Within the Boundaries of Fear, and The Exhausting Appraisal of Relationships. While the older adults struggled to manage their FOF, a deeper meaning was expressed during a relentless striving for self-preservation. While FOF can be an experience of overwhelming helplessness, the older adults in this study demonstrated personal resiliency, a perspective that is often lacking in the current literature.

Association between multimorbidity and falls and fear of falling among older adults in eastern China: a cross-sectional study.

Growing evidence has reported an association between multimorbidity and falls and fear of falling (FOF) in older adults, however, the results regarding this association from China are limited. Our study aimed to investigate the association between multimorbidity and falls and FOF in older adults in eastern China. We conducted a cross-sectional study in Zhejiang Province, Eastern China, which recruited a provincial representative sample of adults aged ≥ 60 years. A structured questionnaire including demographic characteristics, chronic diseases, history of falls in the past 12 months, and FOF, was administered by all participants. The exposure variable was multimorbidity, which was defined as the presence of two or more chronic diseases and medical conditions in the same individual. The outcomes included a history of falls and FOF. Multivariate logistic regression was used to evaluate the association between multimorbidity and falls and FOF in older adults. In total of 7,774 participants were included in the analysis, among whom 3,898 (50.1%) were female, with a mean ± standard deviation age is 72.9 ± 8.4 years. Multimorbidity was associated with the increased risk of falling in older adults [adjusted odds ratio (OR), 1.99; 95% confidence interval (CI):1.55-2.36]. The ORs for having experienced single fall and repeated falls were 1.85 (95% CI: 1.42-2.42) and 3.45 (95% CI: 1.47-6.97), respectively, with multimorbidity compared with those without chronic diseases. The older adults with multimorbidity were more likely to report FOF compared with those without chronic diseases (adjusted OR, 1.49; 95%CI:1.30-1.70). Moreover, the association between multimorbidity and FOF remained significant in the older adults with a history of fall (OR, 1.57; 95%CI:1.04-2.38). The association between multimorbidity and falls and FOF is significant in the Chinese population and the effects of multimorbidity on falls and FOF do not vary according to the frequency and history of falls in older adults.