Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T09:20:24.489Z Has data issue: false hasContentIssue false
  • English
  • Français

Measuring fear of falling and its effect on quality of life and activity

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  27 July 2010

J Perez-Jara ,
D Walker ,
P Heslop  and
S Robinson
J Perez-Jara*
Affiliation:
Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne, UK Hospital El Bierzo, Ponferrada, Leon, Spain
D Walker
Affiliation:
Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne, UK
P Heslop
Affiliation:
Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne, UK
S Robinson
Affiliation:
Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne, UK
*
Address for correspondence: Dr Javier Perez-Jara, Room 79A, Musculoskeletal Department, Freeman Hospital, Freeman Road, Newcastle upon Tyne NE7 7DN, United Kingdom. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

In this review, we analyse original research articles in English and Spanish in which fear of falling (FoF) as a long-term syndrome defines the participants, or is the main outcome, or in cases where FoF is a secondary outcome, falls or activity are the main outcomes.

FoF is difficult to measure. Attempts are made to do so by use of single questions or scales. Restriction in activity due to FoF is a secondary outcome and can be an important influence on a person's quality of life. There are also various methods of measuring it by use of single questions or scales, and general questions in basic or instrumental activities of daily living (ADL) indices are frequently used. Other scales or questionnaires about quality of life (such as the SF-36) or activity (such as the Survey of Activity and Fear of Falling Scales (SAFE), or the Groningen Activity Restriction Scale (GARS)) are also used. The varying objectives of the analysed articles explain some of the variations in measures used. Further work is required to reach a consensus on definition and standardized measurement of FoF and its effect on quality of life and activity.

Keywords

fallsfear of fallingactivityactivity restrictionmeasurementolder people
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 20 , Issue 4 , November 2010 , pp. 277 - 287
Copyright
Copyright © Cambridge University Press 2010

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.)

References

1NICE. Falls: The Assessment and Prevention of Falls in Older People. NICE Clinical Guidelines, CG 21. London, NICE 2004. Available at: http://www.nice.org.uk/guidance (accessed November 2009).Google Scholar
2Scheffer, AC, Schuurmans, MJ, van Dijk, N, Van Der Hooft, T, de Rooij, SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 2008; 37: 19–24.Google Scholar
3Alarcón, T, González-Montalvo, JI, Otero Puime, A. Assessing patients with fear of falling. Does the method use change the results? A systematic review. Aten Primaria 2009; 41: 262–68.CrossRefGoogle ScholarPubMed
4Evitt, CP, Quigley, PA. Fear of falling in older adults: a guide to its prevalence, risk factors, and consequences. Rehabil Nurs 2004; 29: 207–10.Google Scholar
5Legters, K. Fear of falling. Phys Ther 2002; 82: 264–72.Google Scholar
6Tinetti, ME, Richman, D, Powell, L. Falls efficacy as a measure of fear of falling. J Gerontol 1990; 45: 239–43.CrossRefGoogle ScholarPubMed
7Arfken, CL, Lach, HW, Birge, SJ, Miller, JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Pub Health 1994; 84: 565–70.CrossRefGoogle ScholarPubMed
8Cumming, RG, Salkeld, G, Thomas, M, Szonyi, G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci 2000; 55: M299–305.CrossRefGoogle ScholarPubMed
9Lach, HW. Incidence and risk factors for developing fear of falling in older adults. Pub Health Nursing 2005; 22: 45–52.CrossRefGoogle ScholarPubMed
10Vellas, BJ, Wayne, SJ, Romero, LJ, Baumgartner, RN, Garry, PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing 1997; 26: 189–93.Google Scholar
11Murphy, J, Isaacs, B. The post-fall syndrome. A study of 36 elderly patients. Gerontology 1982; 28: 265–70.Google Scholar
12Walker, JE, Howland, J. Falls and fear of falling among elderly persons living in the community: occupational therapy interventions. Am J Occup Ther 1991; 45: 119–22.Google Scholar
13Maki, BE, Holliday, PJ, Topper, AK. Fear of falling and postural performance in the elderly. J Gerontol 1991; 46: M123–31.Google Scholar
14Smulders, E, Schreven, C, Weerdesteyn, V, Van Den Hoogen, FH, Laan, R, Van Lankveld, W. Fall incidence and fall risk factors in people with rheumatoid arthritis. Ann Rheum Dis 2009; 68: 1795–96.CrossRefGoogle ScholarPubMed
15Chen, YM, Chen, LK, Lan, JL, Chen, DY. Geriatric syndromes in elderly patients with rheumatoid arthritis. Rheumatology 2009; 48: 1261–64.Google Scholar
16Furuya, T, Yamagiwa, K, Ikai, T, Inoue, E, Taniguchi, A, Momohara, S, Yamanaka, H. Associated factors for falls and fear of falling in Japanese patients with rheumatoid arthritis. Clin Rheumatol 2009; 28: 1325–30.Google Scholar
17Oswald, AE, Pye, SR, O'Neill, TW, Bunn, D, Gaffney, K, Marshall, T, Silman, AJ, Symmons, DP. Prevalence and associated factors for falls in women with established inflammatory polyarthritis. J Rheumatol 2006; 33: 690–94.Google ScholarPubMed
18Armstrong, C, Swarbrick, CM, Pye, SR, O'Neill, TW. Occurrence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis 2005; 64: 1602–4.CrossRefGoogle ScholarPubMed
19Kaz Kaz, H, Johnson, D, Kerry, S, Chinappen, U, Tweed, K, Patel, S. Fall-related risk factors and osteoporosis in women with rheumatoid arthritis. Rheumatology 2004; 43: 1267–71.CrossRefGoogle ScholarPubMed
20Jamison, M, Neuberger, GB, Miller, PA. Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Rheum 2003; 49: 673–80.Google Scholar
21Peterson, EW, Cho, CC, Finlayson, FM. Fear of falling and associated activity curtailment among middle aged and older adults with multiple sclerosis. Multiple Sclerosis 2007; 13: 1168–75.CrossRefGoogle ScholarPubMed
22Balash, Y, Hadar-Frumer, M, Herman, T, Peretz, C, Giladi, N, Hausdorff, JM. The effects of reducing fear of falling on locomotion in older adults with a higher level gait disorder. J Neural Transm 2007; 114: 1309–14.Google Scholar
23Stolze, H, Klebe, S, Zechlin, C, Baecker, C, Friege, L, Deuschl, G. Falls in frequent neurological diseases. Prevalence, risk factors and aetiology. J Neurol 2004; 251: 79–84.Google Scholar
24Burker, EJ, Wong, H, Sloane, PD, Mattingly, D, Preisser, J, Mitchell, CM. Predictors of fear of falling in dizzy and non-dizzy elderly. Psychol Aging 1995; 10: 104–10.CrossRefGoogle Scholar
25Mahoney, FI, Barthel, DW. Functional evaluation: the Barthel Index. Maryland State Med J 1965; 14: 61–65.Google Scholar
26Lawton, MP, Brody, EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.Google Scholar
27Powell, LE, Myers, AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol Med Sci 1995; 50: M28–34.Google Scholar
28Lachman, ME, Howland, J, Tennstedt, S, Jette, A, Assmann, S, Peterson, EW. Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). J Gerontol B Psychol Sci Soc Sci 1998; 53: P43–50.CrossRefGoogle Scholar
29Ingemarsson, AH, Frändin, K, Hellström, K, Rundgren, A. Balance function and fall-related efficacy in patients with newly operated hip fracture. Clin Rehabil 2000; 14: 497–505.CrossRefGoogle ScholarPubMed
30Kempen, GI, Todd, CJ, Van Haastregt, JC, Zijlstra, GA, Beyer, N, Freiberger, E, Hauer, KA, Piot-Ziegler, C, Yardley, L. Cross-cultural validation of the Falls Efficacy Scale International (FES-I) in older people: results from Germany, the Netherlands and the UK were satisfactory. Disabil Rehabil 2007; 29: 155–62.CrossRefGoogle ScholarPubMed
31Kempen, GI, Yardley, L, van Haastregt, JC, Zijlstra, GA, Beyer, N, Hauer, K, Todd, C. The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age Ageing 2008; 37: 45–50.CrossRefGoogle ScholarPubMed
32Cumming, R, Salkeld G, , Thomas, M, Szony, G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci 2000; 55: M299–305.Google Scholar
33Delbaere, K, Bourgois, J, Van Den Noortgate, N, Vanderstaraeten, G, Willems, T, Cambier, D. A home-based multidimensional exercise program reduced physical impairment and fear of falling. Acta Clin Belg 2006; 61: 340–50.Google Scholar
34Denkinger, MD, Igl, W, Coll-Planas, L, Nikolaus, T, Bailer, S, Bader, A, Jamour, M. Practicality, validity and sensitivity to change of fear of falling self-report in hospitalised elderly – a comparison of four instruments. Age Ageing 2009; 38: 108–12.Google Scholar
35Cameron, ID, Stafford, B, Cumming, RG, Birks, C, Kurrle, SE, Lockwood, K, Quine, S, Finnegan, T, Salkeld, G. Hip protectors improve falls self-efficacy. Age Ageing 2000; 29: 57–62.Google Scholar
36Gagnon, N, Flint, AJ, Naglie, G, Devins, GM. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry 2005; 13: 7–14.CrossRefGoogle ScholarPubMed
37Schoenfelder, DP, Rubenstein, LM. An exercise program to improve fall-related outcomes in elderly nursing home residents. Appl Nurs Res 2004; 17: 21–31.CrossRefGoogle ScholarPubMed
38Clague, JE, Petrie, PJ, Horan, MA. Hypocapnia and its relation to fear of falling. Arch Phys Med Rehabil 2000; 81: 1485–88.Google Scholar
39Delbaere, K, Van Den Noortgate, N, Bourgois, J, Vanderstraeten, G, Tine, W, Cambier, D. The Physical Performance Test as a predictor of frequent fallers: a prospective community-based cohort study. Clin Rehabil 2006; 20: 83–90.Google Scholar
40Andresen, EM, Wolinsky, FD, Miller, JP, Wilson, MM, Malmstrom, TK, Miller, DK. Cross-sectional and longitudinal risk factors for falls, fear of falling, and falls efficacy in a cohort of middle-aged African Americans. Gerontologist 2006; 46: 249–57.Google Scholar
41Hatch, J, Gill-Body, K, Portney, L. Determinants of balance confidence in community-dwelling elderly people. Phys Ther 2003; 83: 1072–79.CrossRefGoogle ScholarPubMed
42Legters, K, Verbus, NB, Kitchen, S, Tomecsko, J, Urban, N. Fear of falling, balance confidence and health-related quality of life in individuals with postpolio syndrome. Physiother Theory Pract 2006; 22: 127–35.Google Scholar
43Hellström, K, Lindmark, B. Fear of falling in patients with stroke: a reliability study. Clin Rehabil 1999; 13: 509–17.Google Scholar
44Hill, K, Schwarz, J, Kalogeropoulos, AJ, Gibson, SJ. Fear of falling revisited. Archives Phys Med Rehabil 1996; 77: 1025–29.CrossRefGoogle ScholarPubMed
45Yardley, L, Beyer, N, Hauer, K, Kempen, G, Piot-Ziegler, C, Todd, C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 2005; 34: 614–19.CrossRefGoogle ScholarPubMed
46Schepensa, S, Goldberga, A, Wallace, M. The short version of the Activities-specific Balance Confidence (ABC) scale: Its validity, reliability, and relationship to balance impairment and falls in older adults. Arch Gerontol Geriatr 2010; 51: 9–12.Google Scholar
47Wolf, B, Feys, H, De, Weerdt, Van Der Meer, J, Noom, M, Aufdemkampe, G, Noom, M. Effect of a physical therapeutic intervention for balance problems in the elderly: a single-blind, randomized, controlled multicentre trial. Clin Rehabil 2001; 15: 624–36.Google Scholar
48Ozcan, A, Donat, H, Gelecek, N, Ozdirenc, M, Karadibak, D. The relationship between risk factors for falling and the quality of life in older adults. BMC Public Health 2005; 5: 90.Google Scholar
49Donat, H, Ozcan, A. Comparison of the effectiveness of two programmes on older adults at risk of falling: unsupervised home exercise and supervised group exercise. Clin Rehabil 2007; 21: 273–83.Google Scholar
50Lin, MR, Wolf, SL, Hwang, HF, Gong, SY, Chen, CY. A randomized, controlled trial of fall prevention programs and quality of life in older fallers. J Am Geriatr Soc 2007; 55: 499–506.CrossRefGoogle ScholarPubMed
51Resnick, B, Orwig, D, D'Adamo, C, Yu-Yahiro, J, Hawkes, W, Shardell, M, Golden, J, Zimmerman, S, Magaziner, J. Factors that influence exercise activity among women post hip fracture participating in the Exercise Plus Program. Clin Interv Aging 2007; 2: 413–27.Google Scholar
52Chun, MC, McKee, KJ, Austin, C et al. Post-Traumatic Stress Disorder in older people after a fall. Int J Geriatr Psychiatry 2009; 24: 955–64.Google Scholar
53Huang, TT. Geriatric fear of falling measure: development and psychometric testing. Int J Nurs Stud 2006; 43: 357–65.CrossRefGoogle ScholarPubMed
54Devereux, K, Robertson, D, Briffa, NK. Effects of a water-based program on women 65 years and over: a randomised controlled trial. Aust J Physiother 2005; 51: 102–8.Google Scholar
55Mendes de Leon, CF, Seeman, TE, Baker, DI, Richardson, ED, Tinetti, ME. Self-efficacy, physical decline, and change in functioning in community-living elders: a prospective study. J Gerontol Soc Sci 1996; 51: S183–90.Google Scholar
56Hotchkiss, A, Fisher, A, Robertson, R, Ruttencutter, A, Schuffert, J, Barker, DB. Convergent and predictive validity of three scales related to falls in the elderly. Am J Occup Ther 2004; 58: 100–3.Google Scholar
57Warnke, A, Meyer, G, Bott, U, Mühlhauser, I. Validation of a quality of life questionnaire measuring the subjective fear of falling in nursing home residents. Z Gerontol Geriatr 2004; 37: 459–66.Google Scholar
58Fitzgerald, TG, Hadjistavropoulos, T, MacNab, YC. Caregiver fear of falling and functional ability among seniors residing in long-term care facilities. Gerontology 2009; 55: 460–67.Google Scholar
59Franzoni, S, Rozzini, R, Boffelli, S, Frisoni, GB, Trabucchi, M. Fear of falling in nursing home patients. Gerontology 1994; 40: 38–44.Google Scholar
60Baloh, RW, Spain, S, Socotch, TM, Jacobson, KM, Bell, T. Posturography and balance problems in older people. J Am Geriatr Soc 1995; 43: 638–44.CrossRefGoogle ScholarPubMed
61Wolf, SL, Barnhart, HX, Kutner, NG, McNeely, E, Coogler, C, Xu, T. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc 1996; 44: 489–97.CrossRefGoogle ScholarPubMed
62Talley, K, Wyman, J, Gross, C. Psychometric properties of the activities-specific balance confidence scale and the survey of activities and fear of falling in older women. J Am Geriatr Soc 2008; 56: 328–33.CrossRefGoogle ScholarPubMed
63Austin, N, Devine, A, Dick, I, Prince, R, Bruce, D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc 2007; 55: 1598–603.Google Scholar
64Suzuki, M, Ohyama, N, Yamada, K, Kanamori, M. The relationship between fear of falling, activities of daily living and quality of life among elderly individuals. Nurs Health Sci 2002; 4: 155–61.Google Scholar
65Nilsson, MH, Fransson, PA, Jarnlo, GB, Magnusson, M, Rehncrona, S. The effects of high frequency subthalamic stimulation on balance performance and fear of falling in patients with Parkinson's disease. J Neuroeng Rehabil 2009; 6: 13.Google Scholar
66Martin, FC, Hart, D, Spector, T, Doyle, DV, Harari, D. Fear of falling limiting activity in young-old women is associated with reduced functional mobility rather than psychological factors. Age Ageing 2005; 34: 281–87.Google Scholar
67Logghe, IH, Zeeuwe, PE, Verhagen, AP, Wijnen-Sponselee, RM, Willemsen, SP, Bierma-Zeinstra, SM, van Rossum, E, Faber, MJ, Koes, BW. Lack of effect of Tai Chi Chuan in preventing falls in elderly people living at home: a randomized clinical trial. J Am Geriatr Soc 2009; 57: 70–75.CrossRefGoogle ScholarPubMed
68Reelick, MF, van Iersel, MB, Kessels, RP, Rikkert, MG. The influence of fear of falling on gait and balance in older people. Age Ageing 2009; 38: 435–40.Google Scholar
69Resnick, B, Orwig, D, Hawkes, W, Shardell, M, Golden, J, Werner, M, Zimmerman, S, Magaziner, J. The relationship between psychosocial state and exercise behavior of older women 2 months after hip fracture. Rehabil Nurs 2007; 32: 139–49.Google Scholar
70Resnick, B, Orwig, D, D'Adamo, C, Yu-Yahiro, J, Hawkes, W, Shardell, M, Golden, J, Zimmerman, S, Magaziner, J. Factors that influence exercise activity among women post hip fracture participating in the Exercise Plus Program. Clin Interv Aging 2007; 2: 413–27.Google Scholar
71Tinetti, ME, Mendes de Leon, CF, Doucette, JT, Baker, DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol 1994; 49: M140–47.Google Scholar
72Brouwer, BJ, Walker, C, Rydahl, SJ, Culham, EG. Reducing fear of falling in seniors through education and activity programs: a randomized trial. J Am Geriatr Soc 2003; 51: 829–34.Google Scholar
73Hill, KD, Stinson, AT. A pilot study of falls, fear of falling, activity levels and fall prevention actions in older people with polio. Aging Clin Exp Res 2004; 16: 126–31.Google Scholar
74Lawrence, RH, Tennstedt, SL, Kasten, LE, Shih, J, Howland, J, Jette, AM. Intensity and correlates of fear of falling and hurting oneself in the next year: baseline findings from a Roybal Center fear of falling intervention. J Aging Health 1998; 10: 267–86.Google Scholar
75Tennstedt, S, Howland, J, Lachman, M, Peterson, E, Kasten, L, Jette, A. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol B Psychol Sci Soc Sci 1998; 53: P384–92.Google Scholar
76Fessel, KD, Nevitt, MC. Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis. Arthritis Care Res 1997; 10: 222–28.Google Scholar
77Fagerström, C, Persson, H, Holst, G, Hallberg, IR. Determinants of feeling hindered by health problems in daily living at 60 years and above. Scand J Caring Sci 2008; 22: 410–21.Google Scholar
78Li, F, Fisher, KJ, Harmer, P, McAuley, E, Wilson, NL. Fear of falling in elderly persons: association with falls, functional ability, and quality of life. J Gerontol B Psychol Sci Soc Sci 2003; 58: P283–90.Google Scholar
79Miller, WC, Deathe, AB, Speechley, M, Koval, J. The influence of falling, fear of falling, and balance confidence on prosthetic mobility and social activity among individuals with a lower extremity amputation. Arch Phys Med Rehabil 2001; 82: 1238–44.Google Scholar
80Dennison, AC, Noorigian, JV, Robinson, KM, Fisman, DN, Cianci, HJ, Moberg, P, Bunting-Perry, L, Martine, R, Duda, J, Stern, MB. Falling in Parkinson disease: identifying and prioritizing risk factors in recurrent fallers. Am J Phys Med Rehabil 2007; 86: 621–32.Google Scholar
81Franchignoni, F, Martignoni, E, Ferriero, G, Pasetti, C. Balance and fear of falling in Parkinson's disease. Parkinsonism Relat Disord 2005; 11: 427–33.Google Scholar
82Huang, TT, Wang, WS. Comparison of three established measures of fear of falling in community-dwelling older adults: psychometric testing. Int J Nurs Stud 2009; 46: 1313–19.Google Scholar
83Brownsell, S, Hawley, MS. Automatic fall detectors and the fear of falling. J Telemed Telecare 2004; 10: 262–66.Google Scholar
84Pang, MY, Eng, JJ. Fall-related self-efficacy, not balance and mobility performance, is related to accidental falls in chronic stroke survivors with low bone mineral density. Osteoporos Int 2008; 19: 919–271.Google Scholar
85Petrella, RJ, Payne, M, Myers, A, Overend, T, Chesworth, B. Physical function and fear of falling after hip fracture rehabilitation in the elderly. Am J Phys Med Rehabil 2000; 79: 154–60.Google Scholar
86Manckoundia, P, Gerbault, N, Mourey, F, d'Athis, P, Nourdin, C, Monin, MP, Camus, A, Pfitzenmeyer, P. Multidisciplinary management in geriatric day-hospital is beneficial for elderly fallers: a prospective study of 28 cases. Arch Gerontol Geriatr 2007; 44: 61–70.Google Scholar