Fear of Falling Predicts Incidence of Functional Disability 2 Years Later: A Perspective From an International Cohort Study. (6th December 2017)

• Record Type: Journal Article
• Authors: Auais, Mohammad; French, Simon; Alvarado, Beatriz; Pirkle, Catherine; Belanger, Emmanuelle; Guralnik, Jack
• Is Part Of: Journals of gerontology. Volume 73:Number 9(2018:Sep.)
• Page Start: 1212
• Page End: 1215
• Publication Date: 2017-12-06
• Subjects: Longitudinal -- Functional decline -- Falls-efficacy -- Functional limitation; Geriatrics -- Periodicals; Gerontology -- Periodicals; 618.97
• DOI: 10.1093/gerona/glx237
• Languages: English
• ISSNs: 1079-5006

Abstract

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.