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J Am Med Dir Assoc. 2017 Jul 1;18(7):597-602. doi: 10.1016/j.jamda.2017.01.022.

Self-Reported Unsteadiness Predicts Fear of Falling, Activity Restriction, Falls, and Disability.

Author information

1
The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland. Electronic address: odonogh@tcd.ie.
2
School of Applied Psychology, University College Cork, Cork, Ireland.
3
The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.
4
The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.

Abstract

OBJECTIVE:

To determine if self-reported unsteadiness during walking is associated with fear of falling (FOF), fear-related activity restriction, falls, and disability over 2 years in community-dwelling adults.

DESIGN:

Data were obtained from the first 2 waves of The Irish Longitudinal Study on Ageing, a population-based study.

SETTING:

Participants completed a home-based interview and a center-based health assessment at baseline and a home-based interview at 2 years follow-up.

PARTICIPANTS:

Community-dwelling adults aged ≥65 years, with Mini-Mental State Examination score ≥18 at baseline, and fully observed variables were included in the analyses (N = 1621).

MEASUREMENTS:

Outcome variables were FOF, fear-related activity restriction, recurrent falls, and disability.

RESULTS:

Unsteadiness was independently associated with an increased risk of all outcomes at follow-up after adjusting for sociodemographic variables, and physical, mental, and cognitive health (Incidence Rate Ratio [IRR] range 1.49-2.29; P < .05). All associations were attenuated after adjusting for usual gait speed but remained consistent in direction. The association was strongest for fear-related activity restriction [IRR = 1.82 (1.21-2.73); P < .01]. There was also evidence of an association between unsteadiness and an increased risk of activity restriction in adults who did not report FOF at baseline [IRR = 1.99 (1.10-3.61); P < .05].

CONCLUSIONS:

Self-reported unsteadiness is independently associated with an increased risk of FOF, fear-related activity restriction, recurrent falls, and disability at follow-up. Self-reported balance/steadiness should be included in routine assessment of older adults especially those at risk of falls. As unsteadiness is modifiable, older adults should be targeted for balance-related training or medication review to minimize future risk of these outcomes.

KEYWORDS:

Balance; disabilities; falls; function/mobility

PMID:
28648902
DOI:
10.1016/j.jamda.2017.01.022
[Indexed for MEDLINE]

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