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Clinician Article

Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons.



  • Scheffer AC
  • Schuurmans MJ
  • van Dijk N
  • van der Hooft T
  • de Rooij SE
Age Ageing. 2008 Jan;37(1):19-24. doi: 10.1093/ageing/afm169. (Review)
PMID: 18194967
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Disciplines
  • Geriatrics
    Relevance - 6/7
    Newsworthiness - 5/7
  • Psychiatry
    Relevance - 5/7
    Newsworthiness - 5/7
  • Family Medicine (FM)/General Practice (GP)
    Relevance - 5/7
    Newsworthiness - 4/7
  • FM/GP/Mental Health
    Relevance - 5/7
    Newsworthiness - 4/7
  • General Internal Medicine-Primary Care(US)
    Relevance - 5/7
    Newsworthiness - 4/7

Abstract

BACKGROUND: fear of falling (FOF) is a major health problem among the elderly living in communities, present in older people who have fallen but also in older people who have never experienced a fall. The aims of this study were 4-fold: first, to study methods to measure FOF; second, to study the prevalence of FOF among fallers and non-fallers; third, to identify factors related to FOF; and last, to investigate the relationship between FOF and possible consequences among community-dwelling older persons.

METHODS: several databases were systematically searched, and selected articles were cross-checked for other relevant publications.

RESULTS: a systematic review identified 28 relevant studies among the community-dwelling elderly. Due to the many different kinds of measurements used, the reported prevalence of FOF varied between 3 and 85%. The main risk factors for developing FOF are at least one fall, being female and being older. The main consequences were identified as a decline in physical and mental performance, an increased risk of falling and progressive loss of health-related quality of life.

CONCLUSION: this review shows that there is great variation in the reported prevalence of FOF in older people and that there are multiple associated factors. Knowledge of risk factors of FOF may be useful in developing multidimensional strategies to decrease FOF and improve quality of life. However, the only identified modifiable risk factor of FOF is a previous fall. In order to measure the impact of interventions, a uniform measurement strategy for FOF should be adopted, and follow-up studies should be conducted.


Clinical Comments

FM/GP/Mental Health

There wasn`t much new information in the paper that would be helpful.

General Internal Medicine-Primary Care(US)

This systematic review synthesizes the literature on assessing Fear of Falling (FOF). Useful for understanding the instruments available, the prevalence of FOF, and associated factors. Persons interested in the details of the review will have to go online to look at the tables and appendices.

Geriatrics

A very good study from the point of view of methodology (systematic review), although the results are what would be expected.

Geriatrics

More evidence about a huge syndrome in Geriatric Medicine, but the problem is for now that no one had designed or found a useful way to decrease falling in elderly communities, and as the authors comment, FOF is burdensome even to those who haven`t fell (yet?). We need to take this topic further. We already know and have clinically experienced how a fall affects functionality in persons, but it feels like we are standing in mud and not moving forward.

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