Modified Falls Efficacy Scale Research Articles

Effects of chair yoga therapy on physical fitness in patients with psychiatric disorders: A 12-week single-blind randomized controlled trial

IntroductionSince falls may lead to fractures and have serious, potentially fatal outcomes, prevention of falls is an urgent public health issue. We examined the effects of chair yoga therapy on physical fitness among psychiatric patients in order to reduce the risk of falls, which has not been previously reported in the literature. MethodsIn this 12-week single-blind randomized controlled trial with a 6-week follow-up, inpatients with mixed psychiatric diagnoses were randomly assigned to either chair yoga therapy in addition to ongoing treatment, or treatment-as-usual. Chair yoga therapy was conducted as twice-weekly 20-min sessions over 12 weeks. Assessments included anteflexion in sitting, degree of muscle strength, and Modified Falls Efficacy Scale (MFES) as well as QOL, psychopathology and functioning. ResultsFifty-six inpatients participated in this study (36 men; mean ± SD age, 55.3 ± 13.7 years; schizophrenia 87.5%). In the chair yoga group, significant improvements were observed in flexibility, hand-grip, lower limb muscle endurance, and MFES at week 12 (mean ± SD: 55.1 ± 16.6 to 67.2 ± 14.0 cm, 23.6 ± 10.6 to 26.8 ± 9.7 kg, 4.9 ± 4.0 to 7.0 ± 3.9 kg, and 114.9 ± 29.2 to 134.1 ± 11.6, respectively). Additionally, these improvements were observable six weeks after the intervention was over. The QOL-VAS improved in the intervention group while no differences were noted in psychopathology and functioning between the groups. The intervention appeared to be highly tolerable without any notable adverse effects. ConclusionsThe results indicated sustainable effects of 20-min, 12-week, 24-session chair yoga therapy on physical fitness. Chair yoga therapy may contribute to reduce the risk of falls and their unwanted consequences in psychiatric patients.

Evaluation of the elderly' falls efficacy by their status of having a home accident and daily life activities

A total of 600 older persons from Cebeci district, Ankara province have participated in this study which aimed to evaluate the elderly' falls efficacy by their status of having an accident and daily life activities. Modified Falls Efficacy Scale (MFES), and Katz Daily Activities Scale were used as data gathering tools in this study. The data were analyzed using standard deviation, arithmetic mean, and the student's t-test to compare the two groups, and the analysis of variance in comparison of multiple groups. The results showed that the falls efficacy scores of the older adults who had experienced a home accident within the past year ( =69,15) were lower than those who had not ( =84,33). The falls efficacy scores of the participants decreased with increased dependence in bathing, sitting/standing, toilet, walking, cooking, cleaning and shopping activities. The participants who were older, had lower educational attainment, low monthly income and green cards, and lived with their relatives had lower falls efficacy scores (p<0.05).

Effectiveness of Sensory Motor Training Program in Community Dwelling Elderly Individuals with History of Fall

Background: Falls are major source of death and injury in elderly population. Physiological age related changes in somatosensory, vestibular and visual systems are well documented in older adults. These changes coupled with age related changes in muscle and bones to contribute to an increased risk of falls. The prevalence of fear of falling in community-living elderly ranges between 12% and 65%, and is higher in women than men, commonly occurs after falls, but also occurs without a previous history of fall. Aim and objectives: To study and determine the effectiveness of sensory motor training program in community dwelling elderly individuals with history of fall. Methodology: Sixty community dwelling elderly individuals were selected from geriatric home care, and study group were form by using purposive sampling. The group under gone sensory motor training program and evaluated on the basis of Berg Balance Scale (BBS), Modified Fall Efficacy Scale (MFES) and Quality of Life (QoL). Intervention used to improve balance consisting of a 45 min. to 1-hour session three times a week. Results: Total 58.33% of patients show, one fall in previous year while 41.67% of patients show two falls in previous year. The mean of BBS at baseline was 39.95 ± 6.32, the mean of BBS at 3 months was 46.21 ± 4.66 and the mean of BBS at 6 months was 43.63 ± 5.10, which is statistically significant (p<0.0001). The mean of MFES at baseline was 4.92 ± 0.39, the mean of MFES at 3 months was 5.71 ± 0.53 and the mean of MFES at 6 months was 5.34 ± 0.51, which is statistically significant (P>0.0001). And finally, for the mean of QoL at baseline was 3.61 ± 0.46, the mean of QoL at 3 month was 4.36 ± 0.42 and the mean of QoL at 6 month was 4.06 ± 0.40, which is statistically significant (p>0.0001). Conclusion: Effect of sensory motor training program shown improvement in balance, reduction in fear of fall, improves quality of life and also helps to prevent fall in community dwelling elderly individuals with history of fall.

Association between Sedentary Behaviour and Physical, Cognitive, and Psychosocial Status among Older Adults in Assisted Living.

Objective Identification of the factors that influence sedentary behaviour in older adults is important for the design of appropriate intervention strategies. In this study, we determined the prevalence of sedentary behaviour and its association with physical, cognitive, and psychosocial status among older adults residing in Assisted Living (AL). Methods Participants (n = 114, mean age = 86.7) from AL sites in British Columbia wore waist-mounted activity monitors for 7 consecutive days, after being assessed with the Timed Up and Go (TUG), Montreal Cognitive Assessment (MoCA), Short Geriatric Depression Scale (GDS), and Modified Fall Efficacy Scale (MFES). Results On average, participants spent 87% of their waking hours in sedentary behaviour, which accumulated in 52 bouts per day with each bout lasting an average of 13 minutes. Increased sedentary behaviour associated significantly with scores on the TUG (r = 0.373, p < 0.001) and MFES (r = −0.261, p = 0.005), but not with the MoCA or GDS. Sedentary behaviour also associated with male gender, use of mobility aid, and multiple regression with increased age. Conclusion We found that sedentary behaviour among older adults in AL associated with TUG scores and falls-related self-efficacy, which are modifiable targets for interventions to decrease sedentary behaviour in this population.

Validation of the Chinese version 10-item Perceived Efficacy in Patient-Physician Interactions scale in patients with osteoarthritis.

ObjectivesThis study aimed to assess the reliability and validity of the Chinese version of the 10-item Perceived Efficacy in Patient–Physician Interaction (PEPPI-10) scale in hospitalized patients with severe knee osteoarthritis in the People’s Republic of China.MethodsBetween January and March 2015, the Chinese versions of PEPPI, self-efficacy for exercise scale, osteoporosis self-efficacy scale, and modified fall efficacy scale were applied to assess 110 severe knee osteoarthritis patients who were hospitalized in the second ward of the department of arthroplasty surgery of Tianjin Hospital.ResultsThe Chinese version of the PEPPI-10 scale had a high coefficient of internal consistency (Cronbach’s α coefficient, 0.907). The score of the Chinese version of PEPPI was weakly correlated with the scores of the Chinese versions of self-efficacy for exercise scale, osteoporosis self-efficacy scale, and modified fall efficacy scale.ConclusionThe Chinese version of the PEPPI-10 scale exhibits sufficient internal consistency and convergent validity in hospitalized patients with severe knee osteoarthritis in the People’s Republic of China.

Validity and reliability of the Chinese version of the Daily Living Self-Efficacy Scale among stroke patients.

The aim of this study was to examine the reliability and validity of the Chinese version of the Daily Living Self-Efficacy Scale (DLSES) in stroke patients. In total, 172 participants were recruited from a local hospital in China. The internal consistent reliability and convergent validity of the total scale and activities of daily living (ADL) and psychosocial functioning subscales were examined and factor analysis was carried out. Cronbach's αs for the Chinese version of the DLSES, ADL subscale, and psychosocial subscale were 0.96, 0.90, and 0.95, respectively. In the factor analysis, two factors (ADL and psychosocial functioning) were extracted, explaining 84.4% of the total variance in self-efficacy (χ/d.f.=2.19, root mean square error of approximation=0.08, normed fit index=0.95, comparative fit index=0.98, incremental fit index=0.98). Convergent validity was confirmed by positive relationships between the Chinese version of the DLSES and the Modified Fall Efficacy Scale (r=0.87). The ADL subscale was associated positively with the Barthel Index (r=0.74) and the psychosocial functioning subscale was associated negatively with the Functional Activities Questionnaire (r=-0.73) and Center for Epidemiologic Studies Depression Scale (r=-0.44). The Chinese version of the DLSES was shown to be a reliable and valid measure of self-efficacy in stroke patients.

Application of motor imagery therapy on the patients with unilateral spatial neglect

Objective To explore the influence of motor imagery therapy on fall efficacy of patients with unilateral spatial neglect. Methods 50 patients with unilateral spatial neglect were selected and divided, according to time of their admission into the hospital, into experimental group and control group, each with 25 cases. Conventional rehabilitation therapy was conducted to both groups, and patients in the experimental group treated with extra motor imagery therapy. Intervention effect of the two groups was compared by Chinese behavioral inattention test-Hong Kong version (CBIT-HK), Modified fall efficacy scale (MFES), Berg Balance Scale (BBS) and Tinetti gait analysis (TGA). Results Before the treatment, scores of patients in the two groups in CBIT-HK, BBS, TGA and MFES had no significant difference (P>0.05). After 8 weeks of treatment, scores of patients in the two groups were all higher than before the treatment (P<0.05), and scores of patients in the experimental group were significantly higher than that in the control group (P<0.05). Conclusions Combination of motor imagery therapy with routine rehabilitation can improve patients′ unilateral spatial neglect, improve their function of balance and gait, improve their fall efficacy and reduce incidence of falling. Key words: Unilateral spatial neglect; Fall efficacy; Motor imagery therapy

Current status and influencing factors of fear of falling among elderly inpatients

Objective To investigate the current status and influencing factors of fear of falling among elderly inpatients, so as to provide theoretical basis for clinical workers in deciding nursing measures for fear of falling. Methods Totals of 180 elderly inpatients in Department of Endocrinology were selected by convenience sampling and were surveyed by questionnaires. Scores of fear of falling of elderly inpatients were assessed by Modified fall efficacy scale (MFES). Influencing factors of fear of falling were analyzed by multiple linear regression of Self-rating anxiety scale (SAS) and Self-rating depression scale (SDS). Results Average scores of fear of falling among elderly inpatients were (5.60±1.50) points; incidence rate of fear of falling was 84.1%. Average scores of anxiety were (50.68±11.56); 100 patients had symptoms of anxiety, with an incidence rate of 61.0%. Average scores of depression were (50.85±11.68); 92 patients had symptoms of depression, with an incidence rate of 56.1%. Differences appeared in the aspects of age, experience of falling, marriage status, whether with walking aid, whether taking special drugs, and status of anxiety and depression (P<0.05). Conclusions Quality of life, physical and psychological health of elderly inpatients were seriously affected, because efficacy scores of fear of falling were low, yet with high incidence rate, and also high incidence rate of anxiety and depression. Medical workers should take effective measures to improve the current status of fear of falling and reduce incidence of falling. Key words: Falling; Elderly; Anxiety; Depression; Questionnaire

Effects of WiiActive exercises on fear of falling and functional outcomes in community-dwelling older adults: a randomised control trial.

the study compares the effects of a Nintendo Wii exercise programme and a standard Gym-based exercise intervention on fear of falling, knee strength, physical function and falls rate in older adults. eighty community-dwelling adults aged 60 years and above with short physical performance battery score of 5-9 points and modified falls efficacy scale (MFES) score of ≤9 points participated in the parallel-group randomised trial. Each intervention arm involved an hour of intervention per week, totalling 12 sessions over 12 weeks. Besides 1-year fall incidence, the participants were evaluated on MFES, knee extensor strength (KES), timed-up-and-go test, gait speed, 6-minute walk test and narrow corridor walk test at weeks 13 and 24. at week 13, between interventions, the effect of MFES changes did not reach statistical significance (difference=-0.07 point, 95% CI -0.56 to 0.42, P=0.78); at week 24, the Wii group showed statistically significant effects over the Gym group (difference=0.8 point, 95% CI 0.27 to 1.29, P<0.01). For KES, the two groups did not differ statistically at week 13 (difference=-2.0%, 95% CI -5.6 to -1.7, P=0.29); at week 24, the Gym group had greater strength gains than the Wii group (difference=-5.1%, 95% CI -8.7 to -1.5, P<0.01). No between-group differences were observed for other outcome measures. on completion of a 12-week Nintendo Wii exercise programme, there was no significant benefit seen on fear of falling when compared to a standard Gym-based exercise intervention; however, post-intervention there was an apparent reduction in fear of falling in the group allocated to Wii training, despite knee strength apparently improving more in those allocated to the Gym. It is possible that long-term gains after using the Wii might be due to a carry-over effect. Australian New Zealand Clinical Trials Registry, ACTRN12610000576022.

Efficacy of Ba Duan Jin in Improving Balance: A Study in Chinese Community-Dwelling Older Adults.

The current quasiexperimental study was intended to determine the efficacy of Ba Duan Jin (translation: eight-section brocade) in improving balance ability of Chinese community-dwelling older adults. The trial group (n = 47) engaged in a Ba Duan Jin exercise program for 12 weeks, whereas the control group (n = 48) participated in a 12-week walking exercise program. After the intervention, participants' balance ability was evaluated using the Timed Up and Go Test (TUGT), One Leg Standing Test (OLST), Berg Balance Scale (BBS), and Modified Falls Efficacy Scale (MFES). Ba Duan Jin was associated with increased TUGT and OLST scores at Week 6 with continuous increases reported through Week 12. Ba Duan Jin was also associated with increased BBS and MFES scores at Week 12. Ba Duan Jin may be an effective means for improving balance ability in Chinese community-dwelling older adults. [Journal of Gerontological Nursing, 42(5), 38-46.].

Investigation on the fall efficacy of elderly people in nursing homes and its influencing factors

Objective To investigate the fall efficacy of elderly people in nursing homes and its influencing factors. Methods A total of 174 elderly people in 8 nursing homes in Fujian province were recruited by convenience sampling method. They were investigated with a self-designed questionnaire about the demographic data, the Modified Falls Efficacy Scale (MFES) and the Kessler Psychological Distress Scale (K10). Results The mean score of fall efficacy was 7.81±1.15, which revealed a middle level. The score of get dressed and undressed scored 9.04±1.42, which was the highest, while the score of using public transport scored 5.80±3.21, which was the lowest. Multiple regression analysis showed that the mental health status, degree of self care, age were influencing factors of fall efficacy of elderly people. Conclusions The fall efficacy level of 174 elderly people is at medium level, which is different among fall efficacy with mental health status, degree of self care, age. Individualized interventions should be designed and provided for them. Key words: Aged; Accidental falls; Nursing homes

Predictors of Falls Efficacy Scale responses among nursing home residents in China

ObjectivesThe objective of this study was to examine the falls efficacy of older adults in nursing homes and the related predictors of falling. MethodsA sample of 317 older adults was recruited from 18 nursing homes in the Fujian province of China. The Modified Falls Efficacy Scale (MFES) and Kessler Psychological Distress Scale (K10) were employed to collect data. ResultsThe falls efficacy of older adults was moderate (7.80 ± 1.17). The falls efficacy questionnaire item “Get dressed and undressed” scored the highest (9.12 ± 1.440), while “Crossing roads” scored the lowest (5.77 ± 3.371). Multiple regression analysis demonstrated that mental health status, degree of self-care, age and gender were each predictors of the falls efficacy of older adults. ConclusionsFalls efficacy enhancing programs for nursing home residents should take mental health status, degree of self-care, age and gender into account.

Safety of intrathecal transplantation of human umbilical cord mesenchymal stem cells for treating hereditary cerebellar ataxia: study protocol for a randomized controlled trial

Background: Intrathecal transplantation of human umbilical cord mesenchymal stem cells (hUCMSCs) has been shown to be effective for treating spinocerebellar ataxia and can improve patient's neurological function to a certain degree without safety concerns. However, further validation by randomized controlled trials is needed. The present study aims to fill this gap.Methods/Design: A single-center, parallel group, open-label, randomized controlled trial will be performed at General Hospital of Chinese Armed Police Forces, China. A total of 100 patients with hereditary cerebellar ataxia will undergo hUCMSC transplantation in the subarachnoid space through lumbar puncture (hUCMSCs transplantation group) or not (control group). The outcome observation time will be designated within 1 week before transplantation, as well as 1, 3, 6, and 12 months after transplantation. Primary outcomes include neurological function evaluation (International Cooperative Ataxia Rating Scale, Modified Falls Efficacy Scale, Berg Balance Assessment, Tremor Rating Scale, and the Timed Up and Go test) and blood tests. Secondary outcomes include electrophysiology examination, mental state evaluation, and urine testing.Discussion: This trial protocol is designed to provide reference data for the safety and rational use of hUCMSC transplantation in the treatment of hereditary cerebellar ataxia.Trial registration: ClinicalTrials.gov identifier: NCT01489267; registered on 30 October 2011. The study protocol has been approved by the ethics committee of the General Hospital of Chinese Armed Police Forces, China (approval No. 201117).

Does vibration training reduce the fall risk profile of frail older people admitted to a rehabilitation facility? A randomised controlled trial

Purpose: To determine the effect of Vibration Training (VT) on functional ability and falls risk among a group of frail older people admitted to an inpatient rehabilitation unit in a regional hospital in New Zealand. Method: A randomized controlled trial of 56 participants (mean 82.01 years in the intervention group and 81.76 years in the control group). VT targeting lower limb muscles with a frequency 30–50 Hz occurred three times per week until discharge. Amplitude progressively increased from 2 to 5 mm to allow the programme to be individually tailored to the participant. The control group received usual care physiotherapy sessions. Outcome measures were: Physiological profile assessment (PPA); and Functional Independence measure (FIM) and Modified Falls Efficacy Scale (MFES). Results: There was a statistically significant difference observed between the two groups in terms of FIM score (F = 5.09, p = 0.03) and MFES (F = 3.52, p = 0.007) but no difference was observed in terms of PPA scores (F = 0.96, p = 0.36). Conclusions: Among older people admitted to an inpatient rehabilitation facility there may be some beneficial effect to the use of VT in conjunction with usual care physiotherapy in terms of improved functional ability. The study design and the small dosage of VT provided may have precluded any change in falls risk among participants.Implications for RehabilitationVibration training (VT) may assist in reducing the risk of falling among at risk older people.Current pressures on health systems (ageing population, reduced hospital length of stay) necessitate the development of innovative strategies to maximise the rehabilitation potential of older people.Among older people admitted to an inpatient rehabilitation facility there may be some beneficial effect to the use of vibration training in conjunction with usual care physiotherapy in terms of improved functional ability.

The Effect of Yoga on Balance and Fear of Falling in Older Adults

ObjectiveTo determine the effect of yoga on balance and fear of falling in older adults. DesignRandomized controlled trial. SettingJahandidegan Center in Shiraz, southern Iran. ParticipantsForty persons (17 men and 23 women) between the ages of 60-74 years with a Modified Falls Efficacy Scale (MFES) score <8 and a Berg Balance Scale (BBS) score <45. After completing the MFES questionnaire and BBS measurement, the participants were divided into intervention and control groups. BBS measurement and the MFES questionnaire were completed again immediately after the intervention. InterventionThe intervention group participated in 2 yoga practice sessions per week for 8 weeks. The control group received no intervention. Main Outcome MeasurementsFear of falling was measured with the MFES and balance was measured with the BBS. ResultsWe found significant changes in both variables (P < .0001). Mean differences before and after the intervention for the BBS for yoga and control groups were 10.19 and –1.16, respectively. Mean differences before and after the intervention for the MFES for yoga and control groups were 1.62 and –0.21, respectively. ConclusionYoga is a potential intervention to reduce fear of falling and improve balance in older adults.

Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females.

The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period.

Old tool, new tricks? A new adaptation of the Modified Falls Efficacy Scale

Aim: Measuring outcomes is important in community rehabilitation programs (CRPs), both at the individual and service level. Identifying global outcome measures that can be used for all patients is challenging given the diversity of this client group. Method: This observational study explored measurement properties of the Modified Efficacy Scale (MES), which is an adaptation of the Modified Falls Efficacy Scale. The MES was used to assess patient confidence in performing activities without reference to falls and was trialled with 221 CRP patients. Floor and ceiling effects, responsiveness to change and minimal clinically important difference (MCID) scores were measured and compared with scores for the same sample of patients using the Lawton Instrumental Activities of Daily Living (IADL) scale. Results: The MES showed evidence of convergent validity and was responsive to change. Both scales showed ceiling effects on discharge, although this was more pronounced with the Lawton IADL scale (40%) than the MES (21%). Both scales had small values for MCID relative to scale width. Conclusions: The MES demonstrated evidence of validity and has a less pronounced ceiling effect compared with the Lawton IADL scale. The implications of a ceiling effect should be considered in the context of the assessment purpose.

Factors affecting the coefficient of variation of stride time of the elderly without falling history: a prospective study.

[Purpose] The purpose of this study was to investigate the factors affecting the coefficient of variation (CV) of stride time in an exercise intervention for the elderly without falling history. [Subjects and Methods] The subjects were 42 elderly women who had participated in a care prevention program for 12 weeks. Stride time CV, motor function, movement ability, balance, Modified Falls Efficacy Scale (MFES) score, and Life-space Assessment (LSA) score before and after the intervention were examined for significant differences using the paired t-test. Multiple regression analysis was used to determine the factors that changed in the stride time CV. [Results] There were significant differences in muscle strength, sit-and-reach flexibility, the one-leg standing time (eyes open), the maximum walking speed, local stability of trunk acceleration, The Timed Up and Go Test (TUG-T), the MFES score, and the LSA score between the pre-intervention and post-intervention. Stepwise multiple regression analysis revealed that improvement of quadriceps muscle strength, sit-and-reach flexibility, the one-leg standing time, TUG-T, local stability of trunk acceleration (vertical direction) and MFES score were independent variables explaining the reduction in stride time CV. [Conclusion] The results was suggested that it might be possible to reduce the stride time CV by improving strength, flexibility and dynamic balance, and reducing fear of falls through interventions.

Seasonal changes in activity levels among nursing care insurance service users in areas with different climates.

[Purpose] To clarify seasonal changes in activity levels among nursing care insurance service users in areas with different climates using the Life Space Assessment. [Subjects] A total of 72 nursing care insurance service users aged ≥65 years, who were from areas along the Sea of Japan or those around the Inland Sea. [Methods] The subjects were divided into 2 groups according to their home prefecture, and each survey was conducted over two successive seasons (Survey I: fall and winter, n=48, Survey II: winter and spring, n=24). We investigated the subjects’ basic information, and determined their FIM, the Life Space Assessment, and Modified Falls Efficacy Scale scores. These scores were subjected to between-group and -season comparisons. [Results] In Survey I, there were no significant differences in any investigation item between the 2 groups, but the Japan Sea group showed decreases in the Life Space Assessment, Independent Life space, and Minimal Life space scores in winter. In Survey II, we did not note any between-group or -season differences. [Conclusion] Our findings suggest that the Life Space Assessment, whose scores are influenced by outdoor environments, may be used as a tool to clarify seasonal changes in activity levels of nursing care insurance service users.

Effect of Fall‐Related Concerns on Physical, Mental, and Social Function in Community‐Dwelling Older Adults: A Prospective Cohort Study

To determine the effect of fall-related concerns on physical, mental, and social function. Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial). Two municipalities in the south of the Netherlands. Community-dwelling older adults (N = 260). Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline. At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months. Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls.