Affective Correlates of Fear of Falling in Elderly Persons

ArticleinAmerican Journal of Geriatric Psychiatry 13(1):7-14 · February 2005with26 Reads
DOI: 10.1176/appi.ajgp.13.1.7 · Source: PubMed
Fear of falling is common in older people, occurring on average in 50% of those who have fallen in the previous year. Little is known about the psychological correlates of fear of falling. The purpose of this study was to determine whether clinically significant depression and anxiety were independently associated with fear of falling. This was a cross-sectional study of 105 persons age > or =60 years, admitted to medical or orthopedic wards, who had fallen at least once in the previous 12 months. Fear of falling was assessed using two different constructs: 1) intensity of fear; and 2) self-efficacy. Depressive and anxiety disorders were assessed with the Structured Clinical Interview for DSM-IV. Depression and anxiety severity were assessed with the Hospital Anxiety and Depression Scale. Demographic, physical, functional, and social variables previously found to be associated with fear of falling were also measured. Logistic-regression and multiple-regression analyses were used to examine the independent association of affective variables with fear of falling. Depressive disorders, anxiety disorders, depression severity, and anxiety severity had significant independent associations with both constructs of fear of falling. Of all the variables that were measured, depressive disorders and depression severity had the strongest associations with fear of falling. Affective variables had a stronger association with fear of falling than non-affective variables in a hospital-based group of subjects. Further research is needed to determine whether similar findings occur in a community-based sample of older people.
    • "Falling means to fall or collapse to lower than standing position or to lie on the floor[1]. Thus, falls occur by the complex function of physical factors such as a sense of balance, muscle strength, and flexibility and psychological factors such as fear of falling[2] . Therefore, when confirming the reduction of the risk of falls through intervention to improve this and socially diffusing the results, it is considered that this will form a part of reducing access to health care environment for the elderly population. "
    Conference Paper · Apr 2016 · PLoS ONE
    • "The average age of participants is 77.12 years. Five studies were conducted in Europe3738394041, seven in the USA [24,424344454647, three in Canada484950 , two in Aus- tralia [5,51], one in Hong Kong [52] and two in Israel [53,54]. Ten studies measure fear of falling and ten studies measure falls-efficacy or balance confidence (seeTable 1). "
    [Show abstract] [Hide abstract] ABSTRACT: Fear of falling and other fall-related psychological concerns (FRPCs), such as falls-efficacy and balance confidence, are highly prevalent among community-dwelling older adults. Anxiety and FRPCs have frequently, but inconsistently, been found to be associated in the literature. The purpose of this study is to clarify those inconsistencies with a systematic review and meta-analysis and to evaluate if the strength of this relationship varies based on the different FRPC constructs used (e.g., fear of falling, falls-efficacy or balance confidence). A systematic review was conducted through multiple databases (e.g., MEDLINE, PsycINFO) to include all articles published before June 10th 2015 that measured anxiety and FRPCs in community-dwelling older adults. Active researchers in the field were also contacted in an effort to include unpublished studies. The systematic review led to the inclusion of twenty relevant articles (n = 4738). A random-effect meta-analysis revealed that the mean effect size for fear of falling and anxiety is r = 0.32 (95% CI: 0.22-0.40), Z = 6.49, p < 0.001 and the mean effect size for falls-efficacy or balance confidence and anxiety is r = 0.31 (95% CI: 0.23-0.40), Z = 6.72, p < 0.001. A Q-test for heterogeneity revealed that the two effect sizes are not significantly different (Q(19) = 0.13, p = n.s.). This study is the first meta-analysis on the relationship between anxiety and FRPCs among community-dwelling older adults. It demonstrates the importance of considering anxiety when treating older adults with FRPCs.
    Full-text · Article · Apr 2016
    • "FOF is reported to be associated with several adverse consequences, including mobility or activity restriction and the development of deconditioning [4,6,192021, reduced social interactions [1,3,18], subsequent falls [2,222324 and a poor quality of life which was found to be related to further physical, psychological and mental function declines [18,24]. Previous studies reported that older age, being female [1,2,4,9,10,25], history of previous falls [4,7,9,10], impaired physical performance [11,25,26], depressive disorders [7,9,25,27,28], impaired cognitive function11121325,282930, living alone [6,28] or having fewer social con- tacts [1], poor subjective health [2,4,10,25], lower educational level [10] or illiterate [7], having chronic health conditions [7,10] were relevant risk factors of FOF among older adults living in the community. Interventions including physical training [29,31323334, cognitive training [29,35], and guided relaxation and imagery therapy [36] have revealed effects on decreasing FOF among older people under different conditions. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored. Objectives To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan. Methods This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-To-face interviews. Results A total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling. Conclusions Fear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people. Copyright: © 2016 Chang et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Full-text · Article · Mar 2016
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