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      Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults

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          Abstract

          To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.

          Cross-sectional study between 2011 and 2013.

          Community in which residents voluntarily attended a health examination.

          We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.

          We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.

          The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older ( P < .01), had longer 5 times chair stand time ( P < .01), and more falls in the previous year ( P < .05), pain ( P < .01), and comorbidity ( P < .05). Multivariate logistic regression analysis identified advanced age (odds ratios [OR], 1.57; 95% confidence interval [CI], 1.03–2.39), falls in the previous year (OR, 2.44; 95%CI, 1.29–4.64), and pain (OR, 1.82; 95%CI, 1.03–3.22) in men, and advanced age (OR, 1.59; 95%CI, 1.13–2.24), longer 5 times chair stand times (OR, 1.28; 95%CI, 1.04–1.59), falls in the previous year (OR, 2.59; 95%CI, 1.54–4.34), and pain (OR, 1.65; 95%CI, 1.06–2.55) in women as being independently associated with fear of falling.

          The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.

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          Interventions for preventing falls in older people living in the community

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            Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention.

            Previous cross-sectional studies have shown a correlation between falls and fear of falling, but it is unclear which comes first. Our objectives were to determine the temporal relationship between falls and fear of falling, and to see whether these two outcomes share predictors. A 20-month, population-based, prospective, observational study. Salisbury, Maryland. Each evaluation consisted of a home-administered questionnaire, followed by a 4- to 5-hour clinic evaluation. The 2,212 participants in the Salisbury Eye Evaluation project who had baseline and 20-month follow-up clinic evaluations. At baseline, subjects were aged 65 to 84 and community dwelling and had a Mini-Mental State Examination score of 18 or higher. Demographics, visual function, comorbidities, neuropsychiatric status, medication use, and physical performance-based measures were assessed. Stepwise logistic regression analyses were performed to evaluate independent predictors of falls and fear of falling at the follow-up evaluation, first predicting incident outcomes and then predicting fall or fear-of-falling status at 20 months with baseline falling and fear of falling as predictors. Falls at baseline were an independent predictor of developing fear of falling 20 months later (odds ratio (OR) = 1.75; P <.0005), and fear of falling at baseline was a predictor of falling at 20 months (OR = 1.79; P <.0005). Women with a history of stroke were at risk of falls and fear of falling at follow-up. In addition, Parkinson's disease, comorbidity, and white race predicted falls, whereas General Health Questionnaire score, age, and taking four or more medications predicted fear of falling. Individuals who develop one of these outcomes are at risk for developing the other, with a resulting spiraling risk of falls, fear of falling, and functional decline. Because falls and fear of falling share predictors, individuals who are at a high risk of developing these endpoints can be identified.
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              Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people.

              Little is known about the prevalence rates and correlates of fear of falling and avoidance of activity due to fear of falling in the general population of community-living older people. To assess prevalence rates and study correlates of fear of falling and avoidance of activity due to fear of falling in this population. cross-sectional study in 4,031 community-living people aged > or =70 years. Fear of falling was reported by 54.3% and associated avoidance of activity by 379% of our population. Variables independently associated with fear of falling were: higher age (> or =80 years: odds ratio (OR) =1.79; 95% confidence interval (CI) =1.49-2.16), female gender (OR = 3.23; 95% CI = 2.76-3.79), poor perceived general health (OR = 6.93; 95% CI = 4.70-10.21) and multiple falls (OR = 5.72; 95% CI = 4.40-7.43). Higher age (> or =80 years: OR = 1.92; 95% CI = 1.59-2.32), poor perceived general health (OR = 11.91; 95% CI = 8.38-16.95) and multiple falls (OR = 4.64; 95% CI = 3.73-5.76) were also independently associated with avoidance of activity. Fear of falling and avoidance of activities due to fear of falling, were highly prevalent in our sample of community-living older people. Particularly, poor perceived general health showed a strong, independent association with both, fear of falling, and related avoidance of activity. Findings of our study may help health care professionals to identify people eligible for interventions aimed at reducing fear of falling and activity restriction.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                January 2018
                26 January 2018
                : 97
                : 4
                : e9721
                Affiliations
                [a ]Department of Public Health
                [b ]Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya
                [c ]Department of Orthopedic Surgery
                [d ]Department of Community Medicine
                [e ]Department of Health Science, Faculty of Medicine Kagoshima University, Kagoshima
                [f ]Department of Health Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
                Author notes
                []Correspondence: Kazuhiko Arima, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan (e-mail: kzarima-ngs@ 123456umin.ac.jp ).
                Article
                MD-D-17-05210 09721
                10.1097/MD.0000000000009721
                5794391
                29369207
                b042c81c-7746-45f5-9bf4-8e04031b4e30
                Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 24 August 2017
                : 4 January 2018
                : 8 January 2018
                Categories
                4600
                Research Article
                Observational Study
                Custom metadata
                TRUE

                falls in the previous year,pain management,physical function

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