scholarly journals Factors influencing Fear of Falling in Community-Dwelling Older Adults in Singapore: A Cross-Sectional Study

Author(s):  
Jacqueline Giovanna De Roza ◽  
David Wei Liang Ng ◽  
Blessy Koottappal Mathew ◽  
Teena Jose ◽  
Ling Jia Goh ◽  
...  

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.

Author(s):  
Jaquelini Betta Canever ◽  
Ana Lúcia Danielewicz ◽  
Amanda Aparecida Oliveira Leopoldino ◽  
Maruí Weber Corseuil ◽  
Núbia Carelli Pereira de Avelar

Fear of falling and history of falls are frequent situations in older adults, which can be aggravated by sedentary behavior (SB). The objective was to establish SB cutoff values which discriminate falls and fear of falling in older adults and verify the association between these conditions. This was a cross-sectional study including 308 community-dwelling older adults. The SB was assessed by International Physical Activity Questionnaire. The outcomes were history of falling in the last 12 months and fear of falling (higher or equal than 23 points in Falls Efficacy Scale International—Brazil). The cutoff points found were >4.14 (area under curve = 0.60, 95% confidence intervals [CIs] [0.54, 0.65]) and >3.90 hr per day (area under curve = 0.59, 95% CI [0.53, 0.64]) for fear of falling and history of falls, respectively. Older adults with SB had 1.71 (95% CI [1.03, 2.84]) and 1.75 (95% CI [1.06, 2.89]) greater odds of having greater fear of falling and suffering falls, respectively.


2021 ◽  
Vol 9 ◽  
Author(s):  
Karina Stella Aoki Ferreira ◽  
Tamires Terezinha Gallo da Silva ◽  
Jarbas Melo Filho ◽  
Natacha Verônica Bazanella ◽  
Audrin Said Vojciechowski ◽  
...  

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL—Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults.Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL—Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used.Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL—Self-reported version was ICC 0.83 (IC95%, 0.70–0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74–0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls.Conclusions: The HOME FAST BRAZIL—Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.


2021 ◽  
Author(s):  
Chang Won Won ◽  
Yunsoo Soh

Abstract Background: Falls are one of the most serious health problems among older adults. Sarcopenia is characterized by a decrease in muscle mass, strength, and physical function. Due to potentially age-related conditions, both falls and sarcopenia have common risk factors. However, the association between sarcopenia and falls is controversial.Methods: In this cross-sectional study, we used data from the Korean Frailty and Aging Cohort Study; 2,323 community-dwelling older adults (1,111 men and 1,212 women) aged 70–84 years were recruited in this cross-sectional study. To evaluate sarcopenia, the Asian Working Group for Sarcopenia (AWGS) diagnostic algorithm was used. We compared the faller and non-faller groups. Unadjusted and fully adjusted logistic regression analyses were performed to evaluate the relationship between sarcopenia and falls.Results: A total of 239 (24.1%) women in the faller group had a history of falls in the past year, which was statistically higher than that in men (176, 15.8%). In the fully adjusted model, handgrip strength (odds ratio [OR]=1.508, 95% confidence interval [CI]=1.028–2.211), short physical performance battery (OR=2.068, 95% CI=1.308–3.271), and 4-m walking speed (OR=3.499, 95% CI=2.044–5.991) were significantly lower in the male faller group. However, the female faller group only showed a significantly low appendicular skeletal muscle mass index (OR=1.419, 95% CI=1.058–1.903) in the fully adjusted model.Conclusions: This large cohort study aimed to identify the incidence of sarcopenia in older Korean population using the AWGS diagnostic algorithm and its correlation with falls. The incidence of falls did not increase in the sarcopenia group. Among the sarcopenia components, sex differences affect the a history of falls. Therefore, when studying the risk of falls in old age, sex differences should be considered.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034189
Author(s):  
Dhammika Deepani Siriwardhana ◽  
Manuj Chrishantha Weerasinghe ◽  
Greta Rait ◽  
Shaun Scholes ◽  
Kate R Walters

ObjectiveWe examined the association between frailty and disability in rural community-dwelling older adults in Kegalle district of Sri Lanka.DesignA population-based cross-sectional study.ParticipantsA total of 746 community-dwelling adults aged ≥60 years.Primary and secondary outcome measuresFrailty was assessed using the Fried phenotype. Disability was operationalised in terms of having one or more activity limitation/s in instrumental activities of daily living (IADL) and basic activities of daily living (BADL).ResultsThe median age of the sample was (median 68; IQR 64–75) years and 56.7% were female. 15.2% were frail and 48.5% were prefrail. The prevalence of ≥1 IADL limitations was high, 84.4% among frail adults. 38.7% of frail adults reported ≥1 BADL limitations. Over half of frail older adults (58.3%) reported both ≥1 physical and cognitive IADL limitations. Being frail decreased the odds of having no IADL limitations, and was associated with a higher count of IADL limitations. No significant association was found between prefrailty and number of IADL limitations.ConclusionsThe prevalence of ≥1 IADL limitations was high among rural community-dwelling frail older adults. Findings imply the greater support and care required for rural Sri Lankan frail older adults to live independently in the community.


2014 ◽  
Vol 94 (10) ◽  
pp. 1410-1420 ◽  
Author(s):  
Brendon Stubbs ◽  
Laura H.P. Eggermont ◽  
Sandhi Patchay ◽  
Pat A. Schofield

Background Pain interference and psychological concerns related to falls (PCRF) are pervasive phenomena among community-dwelling older adults, yet their association remains elusive. Objective The purpose of this study was to establish whether pain interference is associated with PCRF in community-dwelling older adults. Design This was a multisite cross-sectional study. Method Two hundred ninety-five community-dwelling older adults (mean age=77.5 years, SD=8.1; 66.4% female) participated in the study. All participants completed the Brief Pain Inventory (BPI) interference subscale, Short Falls Efficacy Scale–International (FES-I), Activities-specific Balance Confidence Scale (ABC), modified version of the Survey of Activities and Fear of Falling in Elderly Scale (mSAFFE), and Consequences of Falling Scale (CoF). Hierarchical multiple regression analysis were conducted. In the first step of the study, sociodemographic and known risk factors for psychological concerns related to falls were inserted into the model, followed by the BPI interference subscale score in the second step. Results One hundred sixty-nine participants (57.3%) reported some pain interference. The BPI interference subscale was highly correlated with all PCRF (r>.5, P<.0001). After the adjustment for established risk factors, the BPI interference subscale significantly increased the variance in the Short FES-I (R2 change=13.2%), ABC (R2 change=4.7%), mSAFFE (R2 change=5.0%), and CoF (R2 change=10.0%). Pain interference was a significant and independent predictor in the final model for the Short FES-1 (β=0.455, P<.001), ABC (β=−0.265, P<.001), mSAFFE (β=0.276, P<.001), and CoF (β=0.390, P<.001). Limitations The study was cross-sectional. Conclusions Pain interference is an important contributing factor in each of the psychological concerns related to falls. Pain interference had the strongest impact on reducing falls efficacy and increasing older adults' concerns about the consequences of falling.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 813-813
Author(s):  
Ladda Thiamwong

Abstract An instrument to measure healthy aging has not been validated in older adults with and without fear of falling, expressing a methodological gap that limits research in this field. This cross-sectional study aimed to validate the 35-item Healthy Aging Instrument (HAI) in adults aged 60 years and over. 389 community-dwelling older adults from two provinces in Thailand were recruited. The mean age of participants was 70.4 years, and 63% were women. The HAI showed good construct validity and internal reliability in the total group and subgroups with respect to levels of fear of falling. All correlations among the HAI, Fall Risk Assessment Test, Fall Efficacy Scale-International, and full tandem stance test were significant. While Western cultures value the expression of thoughts and feelings, it is not particularly encouraged in Asian cultures. The HAI demonstrates good psychometric properties and provides the basis for measuring healthy aging in Asian older adults.


Author(s):  
Yoshihiro Kugimiya ◽  
Masanori Iwasaki ◽  
Yuki Ohara ◽  
Keiko Motokawa ◽  
Ayako Edahiro ◽  
...  

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.


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