Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T17:51:11.579Z Has data issue: false hasContentIssue false
  • English
  • Français

Fear of Falling in Older Adults with Diabetes Mellitus: The IMIAS Study

Published online by Cambridge University Press:  29 June 2018

Patricia Hewston ,
Angeles Garcia ,
Beatriz Alvarado  and
Nandini Deshpande Open the ORCID record for Nandini Deshpande [Opens in a new window]
Patricia Hewston
Affiliation:
School of Rehabilitation Therapy, Queen’s University, Kingston
Angeles Garcia
Affiliation:
Department of Medicine, Division of Geriatrics, Queen’s University, Kingston
Beatriz Alvarado
Affiliation:
Department of Public Health Sciences, Queen’s University, Kingston
Nandini Deshpande*
Affiliation:
School of Rehabilitation Therapy, Queen’s University, Kingston
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Nandini Deshpande, PT, PhD School of Rehabilitation Therapy Queen’s University Kingston, ON, K7L 3N6 <[email protected]>
Get access Rights & Permissions [Opens in a new window]

Abstract

Several determinants of developing fear of falling (FoF) overlap with the consequences of diabetes mellitus (DM). We compared the prevalence and severity of FoF in older adults with and without DM and identified which FoF determinants contribute to FoF severity in older adults with DM. We used Canadian baseline data from the International Mobility in Aging Study (IMIAS) which identified 141 older adults with DM (DM-group;age:68.88±2.80years) and 620 without DM (noDM-group;age:68.81±2.68years). FoF was quantified with Falls Efficacy Scale–International (FES-I). FoF determinants were evaluated in demographic/health-related, physical, psychological, and social domains. High concern of FoF was more prevalent and of higher severity in 10/16 FES-I activities in the DM-group compared to the noDM-group. Higher FoF severity in the DM-group was associated with poor physical performance, being female, fall history, and clinical depressive symptoms. Protocols developed for screening and interventions may reduce FoF severity in this population.

Résumé

Plusieurs déterminants associés au développement de la peur de tomber (PT) coïncident avec les conséquences du diabète sucré (DS). Nous avons comparé la prévalence et la sévérité de la PT chez des personnes âgées avec et sans DS, et avons identifié quels déterminants de la PT contribuent à la sévérité de la PT chez les aînés avec DS. Des données de base canadiennes provenant de l’étude ‘International Mobility in Aging Study’ (IMIAS) ont été utilisées. Cent quarante-et-un adultes âgés avec DS ont été identifiés (groupe DS; âge: 68.88±2.80 ans), et 620 ont été classés sans DS (groupe sans DS; âge: 68.81±2.68 ans). La PT a été quantifiée avec l’échelle Falls Efficacy Scale–International (FES-I). Les déterminants de la PT ont été évalués en fonction de variables démographiques liées à la santé, ainsi que selon des variables physiques, psychologiques et sociales. Une préoccupation élevée pour la PT était particulièrement prévalente et sévère pour 10/16 activités FES-I dans le groupe DS, comparativement au groupe sans DS. Une PT plus grave dans le groupe DS était associée à une mauvaise condition physique, au sexe féminin, à un historique de chute et à des symptômes dépressifs. Le développement de protocoles pour le dépistage et d’interventions permettraient de réduire la gravité de la PT dans cette population.

Keywords

agingdiabetes mellitusfear of fallingfallsvieillissementdiabète de type 2peur de chuterchutes
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 37 , Issue 3 , September 2018 , pp. 261 - 269
Copyright
Copyright © Canadian Association on Gerontology 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Thank you to all the older adults for their time and participation, and to the IMIAS team members, universities, and institutes for their continuous support. This work was supported by the Canadian Institutes of Health Research [CIHR grant number: 108751]. This work was also further supported by the Canadian Occupational Therapy Foundation and Ontario Graduate Scholarships to PH.

Conflicts of interest: None declared.

Authors’ contributions: PH: study concept and design, analyses and interpretation of data, wrote first draft, and critically revised the article for important intellectual content. AG and BA: interpretation of data and critically revised the article for important intellectual content. ND: concept and design, analyses and interpretation of data, and critical revision of the article for important intellectual content. All authors provided final approval of the version to be submitted.

References

Bruce, D., Hunter, M., Peters, K., Davis, T., & Davis, W. (2015). Fear of falling is common in patients with type 2 diabetes and is associated with increased risk of falls. Age and Ageing, 44(4), 687–690. http://doi.org/10.1093/ageing/afv024CrossRefGoogle ScholarPubMed
De Yébenes, M. J., Otero, A., Zunzunegui, M. V, Rodríguez-Laso, A., Sánchez-Sánchez, F., & Del Ser, T. (2003). Validation of a short cognitive tool for the screening of dementia in elderly people with low educational level. International Journal of Geriatric Psychiatry, 18(10), 925–936.CrossRefGoogle Scholar
Delbaere, K., Close, J., Brodaty, H., Sachdev, P., & Lord, S. R. (2010). Determinants of disparities between perceived and physiological risk of falling among elderly people: Cohort study. British Medical Journal (Clinical Research Ed.), 341, 1–8. https://www.bmj.com/content/341/bmj.c4165CrossRefGoogle ScholarPubMed
Delbaere, K., Close, J. C. T., Mikolaizak, A. S., Sachdev, P. S., Brodaty, H., & Lord, S. R. (2010). The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age and Ageing, 39(2), 210–216. http://doi.org/10.1093/ageing/afp225CrossRefGoogle ScholarPubMed
Deshpande, N., Metter, E. J., Bandinelli, S., Lauretani, F., Windham, B. G., & Ferrucci, L. (2008). Psychological, physical, and sensory correlates of fear of falling and consequent activity restriction in the elderly: The InCHIANTI study. American Journal of Physical Medicine & Rehabilitation/Association of Academic Physiatrists, 87(5), 354–362. http://doi.org/10.1097/PHM.0b013e31815e6e9bCrossRefGoogle ScholarPubMed
Deshpande, N., Metter, E. J., Lauretani, F., Bandinelli, S., & Ferrucci, L. (2009). Interpreting fear of falling in the elderly: What do we need to consider? Journal of Geriatric Physical Therapy (2001), 32(3), 91–96.CrossRefGoogle Scholar
Donoghue, O. A., Cronin, H., Savva, G. M., O’Regan, C., & Kenny, R. A. (2013). Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults. Gait & Posture, 38(1), 120–4. http://doi.org/10.1016/j.gaitpost.2012.10.023CrossRefGoogle ScholarPubMed
Foote, J., Giuseffi, J., & Munshi, M. N. (2013). Diabetes in the elderly. Current Cardiovascular Risk Reports, S184–190. http://doi.org/10.1007/s12170-010-0117-5Google Scholar
Goldenberg, R., & Punthakee, Z. (2013). Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Canadian Journal of Diabetes, 37(Suppl 1), S8–11. http://doi.org/10.1016/j.jcjd.2013.01.011CrossRefGoogle ScholarPubMed
Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., … Wallace, R. B. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49(2), 85–94.CrossRefGoogle Scholar
Hadjistavropoulos, T., Delbaere, K., & Fitzgerald, T. D. (2011). Reconceptualizing the role of fear of falling and balance confidence in fall risk. Journal of Aging and Health, 23(1), 3–23. http://doi.org/10.1177/0898264310378039CrossRefGoogle ScholarPubMed
Hewston, P., & Deshpande, N. (2016). Falls and balance impairments in older adults with type 2 diabetes: Thinking beyond diabetic peripheral neuropathy. Canadian Journal of Diabetes, (40), 6–9. http://doi.org/10.1016/j.jcjd.2015.08.005CrossRefGoogle Scholar
Ibrahim, T., Alvarado, B., & Zunzunegui, M. (n.d.). Psychometric properties and validation of a social networks and social support measurement tool for use in international ageing research: The International Mobility in Ageing Study. Age and Society.Google Scholar
International Diabetes Foundation. (2017). IDF diabetes atlas (8th ed.) Brussels, BEL: Author. Retrieved from www.diabetesatlas.org/resources/2017-atlas.htmlGoogle Scholar
Janghorbani, M., Van Dam, R. M., Willett, W. C., & Hu, F. B. (2007). Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. American Journal of Epidemiology, 166(5), 495–505.CrossRefGoogle ScholarPubMed
Lalli, P., Chan, A., Garven, A., Midha, N., Chan, C., Brady, S., … Toth, C. (2013). Increased gait variability in diabetes mellitus patients with neuropathic pain. Journal of Diabetes and Its Complications, 27(3), 248–254. http://doi.org/10.1016/j.jdiacomp.2012.10.013CrossRefGoogle ScholarPubMed
Mayo Clinic. (2013). Tests and procedures: A1C test. Retrieved from http://www.mayoclinic.org/tests-procedures/a1c-test/basics/results/prc-20012585Google Scholar
Munshi, M. N., Hayes, M., Iwata, I., Lee, Y., & Weinger, K. (2012). Which aspects of executive dysfunction influence ability to manage diabetes in older adults? Diabetic Medicine, 29(9), 1171–1177. http://doi.org/10.1111/j.1464-5491.2012.03606.xCrossRefGoogle ScholarPubMed
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S, Whitehead, V., Collin, I., … Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–699.CrossRefGoogle ScholarPubMed
Pirkle, C. M., de Albuquerque Sousa, A. C. P., Alvarado, B., & Zunzunegui, M.-V. (2014). Early maternal age at first birth is associated with chronic diseases and poor physical performance in older age: Cross-sectional analysis from the International Mobility in Aging Study. BMC Public Health, 14, 293. http://doi.org/10.1186/1471-2458-14-293CrossRefGoogle ScholarPubMed
Pohl, P., Ahlgren, C., Nordin, E., Lundquist, A., & Lundin-Olsson, L. (2015). Gender perspective on fear of falling using the classification of functioning as the model. Disability and Rehabilitation, 37(3), 214–222. http://doi.org/10.3109/09638288.2014.914584CrossRefGoogle ScholarPubMed
Powell, M. W., Carnegie, D. H., & Burke, T. J. (2006). Reversal of diabetic peripheral neuropathy with phototherapy (MIRE) decreases falls and the fear of falling and improves activities of daily living in seniors. Age and Ageing, 35(1), 11–16. http://doi.org/10.1093/ageing/afi215CrossRefGoogle ScholarPubMed
Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.CrossRefGoogle Scholar
Roman de Mettelinge, T., Cambier, D., Calders, P., Van Den Noortgate, N., & Delbaere, K. (2013). Understanding the relationship between type 2 diabetes mellitus and falls in older adults: A prospective cohort study. PloS One, 8(6), e67055. http://doi.org/10.1371/journal.pone.0067055CrossRefGoogle ScholarPubMed
Rybak, L. (1995). Metabolic disorders of the vestibular system. Otolaryngology Head Neck Surg, 112(1), 508–515.CrossRefGoogle ScholarPubMed
Scheffer, A. C., Schuurmans, M. J., Dijk, N., Hooft, T., & Rooij, S. E. (2008). Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37(1), 19–24. http://doi.org/10.1093/ageing/afm169CrossRefGoogle ScholarPubMed
Sharaf, A., & Ibrahim, H. (2008). Physical and psychosocial correlates of fear of falling among older adults in assisted living facilities. Journal of Gerontological Nursing, 34(12), 27–35. Retrieved from https://ogg.osu.edu/media/documents/sage/Sharaf_article_week_3.pdfCrossRefGoogle ScholarPubMed
Volpato, S., Leveille, S. G., Blaum, C., Fried, L. P., & Guralnik, J. M. (2005). Risk factors for falls in older disabled women with diabetes: The Women’s Health and Aging Study. Journals of Gerontology – Series A Biological Sciences and Medical Sciences, 60(12), 1539–1545.CrossRefGoogle ScholarPubMed
Young, W. R., & Williams, M. A. (2015). How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations. Gait & Posture, 41(1), 7–12. http://doi.org/10.1016/j.gaitpost.2014.09.006CrossRefGoogle ScholarPubMed
Zunzunegui, M. V., Alvarado, B. E., Guerra, R., Gómez, J. F., Ylli, A., Guralnik, J. M., & IMIAS Research Group. (2015). The mobility gap between older men and women: The embodiment of gender. Archives of Gerontology and Geriatrics, 61(2), 140–148. http://doi.org/10.1016/j.archger.2015.06.005CrossRefGoogle ScholarPubMed