Comparison of Risk Factors of Falls Between Older Community Dwellers With and Without Fear of Falling

Abstract

Abstract Background: Given that both falls and fear of falling (FOF) share many risk factors among older adults, differences in risk factors of falls between older adults with and without FOF have been reportedly limited. Objective: This study aimed to compare the risk factors of falls between older adults with and without FOF using a two-wave cohort dataset. Method: The study sample included 600 people aged 70.8–96.1 years (mean 76.6, standard deviation 4.6 in 1996)who finished two waves of community survey through a face-to-face questionnaire interview. The outcome of interest was overall fall experience in two surveys. The chi-square test was used to examine differences in the prevalence of falls across explanatory variables, including sociodemographic factors, postural stability (balance and gait maneuverability), sensory factors (Parkinson’s disease, vision, and hearing), number of comorbidities, number of medications, geriatric syndromes (urinary incontinence, depressive symptoms, cognitive impairment, and FOF), lifestyle (alcohol drinking and physical activity level), and environmental home hazards. The potential risk predictors significantly associated with the risk of falls in the chi-square test were examined with univariate logistic regression modeling and included in a multivariate logistic regression model with backward stepwise selection after forcibly including FOF into the model.All analyses were further stratified by FOF to compare the risk factors of falls among older adults with and without FOF. Results: The overall prevalence of falls and FOF were 20.8% and 48.5%, respectively. Bivariate analyses revealed that explanatory variables significantly associated with the risk of falls included sex, marital status, number of instrumental activities of daily living difficulty, use of a walking aid, self-rated health, balance/gait maneuverability, vision, number of comorbidities, depressive symptoms, FOF, and PASE score. Multivariate logistic regression models revealed that older adults with FOF shared several predictors of risk for falls, including impaired gait maneuverability, depressive symptoms, and the number of comorbidities. Conclusion: The study reveals that most modifiable risk factors for falls were more concentrated in older adults with FOF than those without FOF. Study results support the risk stratification of current clinical fall prevention guidelines. FOF experiences combined with other relevant risk factors might be used to classify the target population for fall prevention interventions.