Affective Correlates of Fear of Falling in Elderly Persons

Department of Psychiatry, University of Toronto, Ontario, M5G 2C4, Canada.
American Journal of Geriatric Psychiatry (Impact Factor: 4.24). 02/2005; 13(1):7-14. 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.

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    • "Fear of falling (FOF) is a common problem among the elderly, and in many cases becomes their main cause for concern (Howland et al., 1993). Its prevalence ranges from 21% to 85% in people who have previously fallen, and from 33% to 46% in those who have not (Gagnon, Flint, Naglie, & Devins, 2005; Jørstad, Hauer, Becker, & Lamb, 2005; Scheffer, Schuurmans, van Dijk, van der Hooft, & de Rooij, 2008; Vellas et al., 1997). Different studies have found a greater prevalence of FOF in older people, in women, in institutionalised people and in subjects who present balance problems (Tuunainen et al., 2014), cognitive decline or low income (Arfken, Lach, Birge, & Miller, 1994; Bruce, Devine, & Prince, 2002; Franzoni, Rozzini, Boffelli, Frisoni, & Trabucchi, 1994; Howland 0167-4943/ ã 2015 Elsevier Ireland Ltd. "
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    ABSTRACT: Fear of falling (FOF) is a common problem among the elderly. The purpose of this study is to evaluate whether there is a correlation between FOF, estimated via the short FES-I test, and objective evaluation of balance in a group of elderly patients with age-related instability. The balance of 139 subjects of more than 65 years of age is evaluated by the timed up and go test and the computerised dynamic posturography (CDP). Different groups of elderly patients were established according to the number of falls in the previous 12 months, and the correlation with short FES-I test scores was evaluated. Based on the results, ROC curves were calculated. The short FES-I test presents a good capacity to distinguish between subjects with ≤3 falls/year and subjects with ≥4 falls/year (AUC 0.719, 95%CI 0.627-0.810). A test score of 14.5 is the best cut-off point (74% sensitivity, 51% specificity). Using this cut-off point, the study sample comprises two groups: subjects with test scores of 7-14 vs 15-28, with the first group obtaining best results with statistical significance (Student's t-test and the Mann-Whitney test) in most of the balance tests. The short FES-I is an excellent instrument that measures FOF in the elderly, and it is correlated with their number of falls both in real life and on the CDP. It is simple and fast, and so can be considered an extraordinary screening test relative to real risk of falls in the elderly.
    No preview · Article · Sep 2015 · Archives of gerontology and geriatrics
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    • "It should be noted that in terms of the nature of the fall issue, some or all of the consequences may also cause another fall, which creates a vicious circle. For instance, the fear of falling [36] is one of the most mentioned fall causes, which is at the same time an important consequence of the fall. In addition, we consider a linear effect of the number of falls on the consequences, for instance on the lowering of quality of life. "
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    ABSTRACT: Assessing the number of users defined by a set of specific usage attributes in a given usage contextual situation is not always an obvious task in a market segmentation process. Although new approaches in design and marketing seem to be more sensitive to the adequacy of a design concept with the usage scenarios, these methods do not systematically consider the various usage situations. The present article puts forward a methodology intending to build a usage scenarios space in which the input data is thoroughly collected and validated. This methodology is applied to the complex and multifactorial issue of falls among the elderly in the Metropolitan France. In this paper, numerous medical publications have been made to study influential factors of fall situations. However, even solution providers for fall prevention and teleassistance ignore the real situational coverage of their solutions. As a result, “usage scenarios space” is built using an appropriate segmentation of usage contexts (here, fall situations) and user characteristics. These data are used for a design oracle to predict (simulate) the various and multiple usage scenarios.
    Full-text · Conference Paper · Aug 2013
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    • "Although FoF may contribute to the risk of falling, it cannot be assumed that it represents the actual risk of falling [5]. FoF is associated with anxiety, depressive symptoms, and reduced quality of life [6], and may lead to unnecessary avoidance of specific activities in older adults, even though they may be able to perform such activities without falling [7] [8]. "
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    ABSTRACT: Little is known about dynamic balance control under dual-task conditions in older adults with fear of falling (FoF). The purpose of this study was to examine the effect of FoF on anticipatory postural adjustment (APA) during gait initiation under dual-task conditions in older adults. Fifty-seven elderly volunteers (age, 79.2 [6.8] years) from the community participated in this study. Each participant was categorised into either the Fear (n=24) or No-fear (n=33) group on the basis of the presence or absence of FoF. Under single- and dual-task conditions, centre of pressure (COP) data were collected while the participants performed gait initiation trials from a starting position on a force platform. We also performed a 10-m walking test (WT), a timed up & go test (TUG), and a functional reach test (FR). The reaction and APA phases were measured from the COP data. The results showed that under the dual-task condition, the Fear group had significantly longer APA phases than the No-fear group, although no significant differences were observed between the 2 groups in the reaction and APA phases under the single-task condition and in any clinical measurements (WT, TUG, and FR). Our findings suggest that specific deficits in balance control occur in subjects with FoF during gait initiation while dual tasking, even if their physical functions are comparable to subjects without FoF.
    Full-text · Article · Feb 2012 · Gait & posture
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