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Impact of fear of falling and fall history on disability incidence among older adults: P rospective cohort study
Author(s) -
Makino Keitaro,
Makizako Hyuma,
Doi Takehiko,
Tsutsumimoto Kota,
Hotta Ryo,
Nakakubo Sho,
Suzuki Takao,
Shimada Hiroyuki
Publication year - 2018
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4837
Subject(s) - fear of falling , medicine , hazard ratio , incidence (geometry) , confidence interval , poison control , cohort , prospective cohort study , gerontology , cohort study , injury prevention , occupational safety and health , fall prevention , physical therapy , demography , medical emergency , surgery , physics , pathology , optics , sociology
Objective Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community‐dwelling older adults from a prospective cohort study. Methods A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49‐55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (−) FOF (−), Fall (+) FOF (−), Fall (−) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long‐term care insurance certification for personal support or care. Results During the follow‐up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long‐term care insurance. Fall (−) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (−) FOF (−) group even after adjusting for covariates (Fall (−) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01‐1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05‐1.98). Conclusions Fear of falling could be a simple and useful predictor of disability incidence in community‐dwelling older adults. Identifying and decreasing fall risk factors may prevent fall‐related injuries, but excessive FOF may be associated with increased risk of disability incidence.