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BACKGROUND: Fear of falling is a loss of confidence in balance which affects the quality of life of the elderly. Falls in older people can result in disability, death, financial stress on the family, and higher medical expenses. A significant proportion of those who fall are said to be afraid of falling. This study determined the prevalence and the factors associated with the fear of falling in the elderly attending the Rivers State University Teaching Hospital, Port Harcourt. METHODS: This was a cross-sectional study of patients, 60 years and older, attending the Family Medicine clinic in the hospital. A questionnaire was used to collect data on the socio-demographic characteristics, history of chronic illness and lifestyle of the respondents. It also included the Modified Fall Efficacy scale to assess the fear of falling in the respondents and the functional assessment of the respondents was also carried out using the Timed Up and Go Test (TUG). Descriptive analysis and logistic regression were done to determine the factors associated with the fear of falling in the elderly. RESULTS: A total of 292 patients consented to participate, Fear of falling was prevalent in 58 (19.9%) of the participants. The female gender was found to have 50% lower odds of having a fear of falling than their male counterparts (O.R.=0.541, 95% C. I=0.327-0.896) An association was found between reduced frequency of physical activity and fear of falling. (χ2=10.25 P-value=0.006) An association was found between fear of falling and TUG as those with a fear of falling took a longer time to complete the TUG test. CONCLUSION: The study suggests that healthcare professionals should routinely investigate the fear of falling in geriatric care to devise preventive and intervention strategies to combat the fear of falling among the elderly.

CONTEXTE: La peur de tomber est une perte de confiance en l'équilibre qui affecte la qualité de vie des personnes âgées. Les chutes chez les personnes âgées peuvent entraîner une invalidité, la mort, une pression financière sur la famille et des dépenses médicales plus élevées. Une proportion significative de ceux qui tombent est dite avoir peur de tomber. Cette étude a déterminé la prévalence et les facteurs associés à la peur de tomber chez les personnes âgées fréquentant l'Hôpital Universitaire de Rivers State, à Port Harcourt. MÉTHODES: Il s'agissait d'une étude transversale des patients âgés de 60 ans et plus, fréquentant la clinique de médecine familiale de l'hôpital. Un questionnaire a été utilisé pour recueillir des données sur les caractéristiques sociodémographiques, les antécédents de maladies chroniques et le mode de vie des répondants. Il comprenait également l'échelle modifiée d'efficacité des chutes pour évaluer la peur de tomber des répondants et l'évaluation fonctionnelle des répondants a également été réalisée à l'aide du test Timed Up and Go (TUG). Des analyses descriptives et une régression logistique ont été effectuées pour déterminer les facteurs associés à la peur de tomber chez les personnes âgées. RÉSULTATS: Un total de 292 patients ont consenti à participer, la peur de tomber était prévalente chez 58 (19,9 %) des participants. Le sexe féminin avait 50 % moins de chances d'avoir peur de tomber que leurs homologues masculins (O.R.=0,541, 95% C.I=0,327-0,896). Une association a été trouvée entre la réduction de la fréquence de l'activité physique et la peur de tomber (χ2=10,25, P-value=0,006). Une association a été trouvée entre la peur de tomber et le TUG, car ceux qui avaient peur de tomber mettaient plus de temps à terminer le test TUG. CONCLUSION: L'étude suggère que les professionnels de la santé devraient systématiquement enquêter sur la peur de tomber dans les soins gériatriques afin de concevoir des stratégies préventives et interventionnelles pour combattre la peur de tomber chez les personnes âgées. MOTS-CLÉS: Peur de tomber, Personnes âgées, Prévalence des chutes, Test Timed Up and Go, Échelle modifiée d'efficacité des chutes.

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Introduction: Fear of falling is a loss of confidence in balance which affects the quality of life of the elderly. Falls in older people can result in disability, death, financial stress on the family, and higher medical expenses and a significant proportion of those who fall are said to be afraid of falling. Objective: To determine the prevalence and the factors associated with Fear of falling in the elderly attending the Rivers State University Teaching Hospital, Port Harcourt. Methodology: A cross-sectional study of patients, 60 years and older, attending the Family Medicine clinic. A questionnaire (which included the Modified Fall Efficacy scale) was used to collect data on the socio-demographic characteristics and fear of falling. The functional assessment of the respondents was done using the Timed Up-and-Go test (TUG). Descriptive analysis and logistic regression were done to determine the factors associated with the fear of falling. Results: Of the 292 respondents, fear of falling was prevalent in 58 (19.9%) of them. The female gender was found to have 50% lower odds of having a fear of falling than their male counterparts (O.R.=0.541, 95% C.I=0.327-0.896). An association was found between fear of falling and TUG as those with a fear of falling took a longer time to complete the TUG test. Conclusion: The study suggests that healthcare professionals should routinely investigate the fear of falling in geriatric care to devise preventive and intervention strategies to combat the Fear of falling among the elderly.

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BACKGROUND: Restriction in physical activity (PA) and social participation restriction (PR) can be heightened in the presence of fear of fall (FOF), fall experience, and perceived unsafe neighborhood, particularly among older adults. Despite the enormous benefits of social participation and physical activity, many older adults remain vulnerable to participation restriction and this probably accounts for a significant proportion of health challenges for older adults. OBJECTIVE: This study investigated the relationship between neighborhood safety (NS), fall indices, physical activity, and social participation restriction among older adults from selected communities in Nsukka, Enugu state, Nigeria. METHODS: This was a cross-sectional survey of 170 recruited via consecutive non-probability sampling techniques. Socio-demographic variables, co-morbidities, and fall prevalence were obtained using a self-administered questionnaire. The study instruments include the PA neighborhood environment scale - Nigeria (PANES-N), PA scale for elderly (PASE), Participation scale (PS), Modified fall efficacy scale (MFES), and Fall risk assessment tool (FRAT) and fall indices. STATISTICAL ANALYSIS: Descriptive statistics of mean and standard deviations, frequency counts, and percentages were used to analyze the socio-demographic variables, and Inferential statistics of Spearman rank order correlation were used to determine the relationship among the neighborhood safety, fall indices, physical activity level, and participation restrictions. RESULTS: PR has a negative relationship with NS (r = -0.19, p- 0.01), and fall efficacy (r = -0.52, p- 0.001). However, PR has a positive relationship with fall risk (r = 0.36, p = 0.001). CONCLUSION: Participation restriction is negatively correlated with neighborhood safety, fall efficacy, and PA. The PR has a positive relationship with fall risk (FR).

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Background: Falls are common, detrimental events among ambulatory individuals with spinal cord injury (SCI). Following SCI, changes to lower limb function are probable and likely to impact an individual's fall risk, yet no comprehensive review has been completed on the topic. Objectives: This study systematically reviewed data on the relationship between lower limb function and fall prevalence in ambulatory individuals with SCI. Methods: A literature search was conducted in PubMed, Web of Science, Scopus, and CINAHL. Two independent reviewers screened abstracts/titles and then full articles. Study details, participants' characteristics, lower limb function assessed, and fall-related data were extracted from the studies. A qualitative analysis of the relationship between lower limb function and fall prevalence was performed. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Results: The search yielded 1553 articles. Eight prospective, two retrospective, and three cross-sectional studies met the eligibility criteria. These studies ranged from low to high risk of bias. Overall, the qualitative analysis provided little evidence to support the relationship between lower limb function recorded by clinical measures and fall prevalence. Conclusion: This review highlights the inconsistent relationship between lower limb function and falls prevalence in ambulatory adults with SCI. Greater uniformity in methodology and consistent categorization of fallers and nonfallers among researchers is necessary to move the field forward. Investigating additional factors such as behavior traits, assistive device use, and environmental risk factors may be appropriate in understanding fall prevalence in this population.

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BACKGROUND: Falls are common in older people. The fear of falling (FOF) can lead elderly persons to restrict their activities which reduces quality of life. We aimed to estimate the prevalence and factors associated with FOF in community-dwelling Thai elderly to improve screening, treatment and prevention policies and practices. OBJECTIVES: We aimed to estimate the prevalence and factors associated with FOF in suburban-dwelling Thai seniors. METHODS: Seniors aged 60-85 years old from 4 suburban communities near Bangkok, Thailand, were interviewed and examined. Questionnaires were used to collect data on the FOF, symptoms of depression, anxiety and balance tests. T tests, χ2 tests, and logistic regressions were used in statistical analysis. RESULTS: 210 subjects were enrolled. The mean age was 70.3, and 74.3% were female. Fifty-three (25.2%) reported a previous history of falls. The prevalence of FOF was 35.8% in the subjects with previous history of falls and 21.7% in subjects without previous history of falls. FOF was associated with female gender, age ≥80, living alone, impaired balance, and functional impairment but not with previous history of falls. CONCLUSION: FOF is associated with balance impairment, anxiety, depression, and functional impairment of daily routine activities.

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The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings (n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance (p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.

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AIM: As a person ages, the risk of falls increases, which affects quality of life and represents a financial burden to health- and social-systems, and a greater morbidity and mortality risk. Falls lead to decreased social contact, anxiety, long-term physical disability, severe dependency and hospitalizations. Currently, few studies address this phenomenon using a uniform methodology; therefore, this study aims to explore the prevalence of falls and associated-variables in older adults across Europe. METHODS: In this cross-sectional analysis, we used data from Wave 6 of SHARE. The prevalence of falls was assessed through the answer "falling down" to the question "For the past six months at least, have you been bothered by any of the health conditions on this card?". Multilevel logistic regression was used, using falls as a dependent variable. Multilevel univariable logistic regression models were made to identify potential associated factors. RESULTS: From the 41,098 participants, 56.3% were female, and the average age was of 70.0 ± 8.9 years. The prevalence of falls was 8.2% (CI 8.0% to 8.4%), being higher in women (10.1% vs. 5.8%) and increasing with age. Age, female gender, being frail or pre-frail, higher scores on the EURO-D scale, polypharmacy and fear of falling were found to be significantly associated with falls. CONCLUSIONS: We found that falls are prevalent in the European community-dwelling population, with variations between countries. As a public health priority, identification of the variables associated with falls is important in order to identify/monitor the risk in older groups and develop tailored and cost-effective interventions for falls prevention.

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BACKGROUND: Muscle weakness and impairments in physical functioning are well-recognised sequelae after critical illness. Whether individuals have a higher risk of community falls and a fear of falling has not been examined amongst individuals after critical illness. OBJECTIVES: The objective of this study was to explore the prevalence of falls, fear of falling, and fall risk in intensive care unit (ICU) survivors over a 6-month period after hospital discharge. METHODS: This was a nested exploratory study within a medical ICU. Fall prevalence was measured in line with established guidelines over 6 months after ICU discharge. Fear of falling and prediction of fall risk were assessed at 2, 4, and 6 months after discharge. RESULTS: Twelve individuals were included. Half of the cohort (n = 6) had at least one fall, with one-third sustaining more than one fall. There were 17 falls reported across the six individuals. Injuries requiring medical intervention were reported with five falls. Almost one-third were classified as 'moderate' to 'severe' injurious falls. Loss of balance and fatigue were reported as the main contributors to the falls. All individuals who had a fall reported a severe fear of falling at 2 months. Individuals classified as having 'moderate' to 'high' risk of falls at 2 months were more likely to have at least one fall. CONCLUSIONS: This study suggests that ICU survivors may have a high fall risk, fear of falling, and fall prevalence, which can result in significant injury.

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OBJECTIVES: To study the fall prevalence, time trends and related risk factors among elderly people in the Chinese mainland from 2011 to 2013. METHODS: Our data were from China Health and Retirement Longitudinal Study in 2011 and 2013. The population sample included people aged 60 years and over. Whether the person had experienced fall accident in the last two years was used to measure fall incidence. The time trend and age groups were investigated through the chi-square test. The related risk factors were examined based on the binary logistic regression model. RESULTS: In 2011, 19.64% (95% CI, 18.66%, 20.67%) of elderly people experienced fall incidents and in 2013, 19.28% (95% CI, 18.46%, 20.13%) of elderly people experienced fall incidents. However, no significant difference was seen in the fall prevalence between 2011 and 2013. The fall prevalence among elderly people aged 66-70 declined significantly while that among people aged over 80 showed an increasing time trend. The fall prevalence was affected significantly by factors including age (66-70), gender, marital status, self-rated health, quantity of chronic diseases, quantity of disability items, activities of daily living and physical functioning. CONCLUSIONS: It is revealed the fall prevalence showed no increment from 2011 to 2013 but at a high level. More efforts should be made to reduce the fall prevalence, and special attention should be paid to the elderly people aged over 80 and older.

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