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J Gerontol A Biol Sci Med Sci. 2018 Aug 10;73(9):1212-1215. doi: 10.1093/gerona/glx237.

Fear of Falling Predicts Incidence of Functional Disability 2 Years Later: A Perspective From an International Cohort Study.

Author information

1
School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
2
Department of Chiropractic, Macquarie University, New South Wales, Australia.
3
Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
4
Office of Public Health Studies, University of Hawaii at Manoa, Honolulu.
5
Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island.
6
Department of Health Services, Policy & Practice, Brown University, Providence, Rhode Island.
7
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.

Abstract

Objective:

To study the extent to which fear of falling (FOF) is associated with the onset of functional disability over a 2-year period in older adults using self-reported and performance-based measures.

Methods:

In 2012, 1,601 participants (aged 65-74 years) were recruited from four sites: Kingston and Saint-Hyacinthe, Canada; Manizales, Colombia; and Natal, Brazil. They were re-assessed in 2014. We quantified FOF using the Fall Efficacy Scale-International (FES-I; range: 16-64). Functional disability measures were (i) self-reported incident mobility disability, defined as difficulty climbing a flight of stairs or walking 400 m and (ii) incident poor physical performance, defined as a score <9 on the Short Physical Performance Battery. In the Poisson regression analysis, we included only those participants without functional disability at baseline to calculate incident risk ratios in 2014.

Results:

1,355 participants completed the 2014 assessment, of which 917 and 1,078 had no mobility disability and poor physical performance at baseline, respectively. In 2014, 131 (14.3%), and 166 (15.4%) participants reported incident mobility disability and poor physical performance, respectively. After adjusting for age, sex, socioeconomic, and health covariates, a one-point increase in FES-I at baseline was significantly associated with a 4% increase in the risk of reporting incident mobility disability (95% CI: 1.02-1.05) and a 3% increase in the risk of developing poor physical performance at follow up in the overall sample (95%CI: 1.01-1.05).

Conclusions:

FOF is associated with a higher risk of incident mobility disability and poor physical performance in a cohort of older adults. It is increasingly important to study FOF's effect on functional disability and to take necessary measures to prevent the transition to end-stage disability.

PMID:
29220420
PMCID:
PMC6093362
[Available on 2019-08-10]
DOI:
10.1093/gerona/glx237

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