Effect of fall-related concerns on physical, mental, and social function in community-dwelling older adults: a prospective cohort study

Erik van der Meulen, G A Rixt Zijlstra, Ton Ambergen, Gertrudis I J M Kempen
Journal of the American Geriatrics Society 2014, 62 (12): 2333-8

OBJECTIVES: To determine the effect of fall-related concerns on physical, mental, and social function.

DESIGN: Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial).

SETTING: Two municipalities in the south of the Netherlands.

PARTICIPANTS: Community-dwelling older adults (N = 260).

MEASUREMENTS: Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline.

RESULTS: At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months.

CONCLUSION: Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls.

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