Fear of falling in robust community-dwelling older people: results of a cross-sectional study.

AIMS AND OBJECTIVES: To identify the prevalence and risk factors for fear of falling among robust community-dwelling older people.

BACKGROUND: Different models including various risk factors emerged when previous studies attempted to explore the factors' multivariate associations with fear of falling. Attempting to detect fear of falling by a single question in some previous studies may not have been sufficiently sensitive, particularly in a robust population. Although some studies used a validated instrument to detect participants' fear of falling, their self-perceived efficacy in performing various activities was seldom reported. Information to provide an insight into the planning of well-targeted interventions to reduce fear of falling has been lacking.

DESIGN: A cross-sectional study of 445 robust community-dwelling older people aged ≥65.

METHODS: Besides their demographic and fall-related background, participants' fear of falling level was assessed using the Chinese Fall Efficacy Scale-International. Other instruments included the timed up and go test, the Chinese Geriatric Depression Scale-Short Form, the Chinese Anxiety Disorder Scale, the Chinese Lubben Social Network Scale and the Chinese Personal Wellbeing Index, which were used to assess different variables that may be associated with fear of falling.

RESULTS: Of the 64·73% of participants who had fear of falling, 65·63% had no history of fall but still had fear of falling. This result was higher than in most previous studies. Participants' main concerns were walking on slippery/uneven surfaces, in crowded places and up/down a slope. Multivariate analyses showed that being female, suffering from poor vision and arthritis, poor performance in the timed up and go test, expressing more depressive and anxiety symptoms and low self-perceived well-being are multiply associated with fear of falling.

CONCLUSION: Fear of falling is prevalent among robust community-dwelling older people regardless of their fall history. They showed lack of self-perceived efficacy in performing various outdoor activities.

RELEVANCE TO CLINICAL PRACTICE: The findings can assist in developing multidimensional strategies for reducing fear of falling in robust community-dwelling older people.