Citation

Belloni G, Büla C, Santos-Eggimann B, Henchoz Y, Seematter-Bagnoud L. J. Am. Med. Dir. Assoc. 2020; ePub(ePub): ePub.

Affiliation

Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Center, Lausanne, Switzerland; Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Copyright

(Copyright © 2020, Lippincott Williams and Wilkins)

DOI

10.1016/j.jamda.2020.01.101

PMID

32165062

Abstract

OBJECTIVES: Fear of falling (FOF) is common in older persons and related to negative outcomes. This study aimed to investigate the relationship between 2 FOF measures: the Falls Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction (SQ-FAR). Factors associated with disagreement between the 2 measures were further examined.

DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Participants (N = 1359) were community-dwelling persons aged 65 to 70 years who were enrolled in the Lausanne cohort 65+.

METHODS: Data included demographic, functional, cognitive, affective, and health status. FOF was measured with FES-I and the 3-level SQ-FAR (no FOF, FOF without activity restriction (AR, FOF with AR). FES-I concern about falling was categorized as low (score 16-19), moderate (score 20-27), and high (score 28-64).

RESULTS: Weighted agreement between the FES-I and the SQ-FAR was 87.8% (Kappa = 0.57). Using the FES-I as gold standard, the performance of SQ-FAR was good (specificity 86%; sensitivity 74%, negative predicting value 89%, positive predicting value 69%). Among participants with moderate/high FOF according to FES-I, male sex (P = .011) and the absence of previous falls (P < .001) were associated with disagreement between the 2 tools. Among participants with low FOF, female sex (P = .005), falls history (P < .001), and pre-frailty/frailty status (P = .050) were associated with disagreement.

CONCLUSIONS AND IMPLICATIONS: The SQ-FAR has a moderate agreement with FES-I and might be used as a screening tool. The results also may help design a step-by-step strategy to evaluate and address FOF in the clinical setting.

Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

FES-I; elderly; fear of falling; healthy aging; older adults