Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline.
Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured.
In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001).
Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted.
ClinicalTrials.gov identifier: NCT01713543.
Ayoung-Chee P, McIntyre L, Ebel BE, Mack CD, McCormick W, and Maier RV. Long-term outcomes of ground-level falls in the elderly . J Trauma Acute Care Surg 2014; 76: 498–503; discussion 503.
Fortinsky RH, Panzer V, Wakefield D. Into F. Alignment between balance confidence and fall risk in later life: has over-confidence been overlooked? Health Risk Soc. 2009;11:341–52. CrossRef
Matchar DB, Duncan PW, Lien CT, Ong MEH, Lee M, Gao F, et al. Randomized controlled trial of screening, risk modification, and physical therapy to prevent falls among the elderly recently discharged from the emergency department to the community: the steps to avoid falls in the elderly study. Arch Phys Med Rehabil. 2017;98:1086–96. CrossRefPubMed
Clark RA, Bryant AL, Pua YH, McCrory P, Bennell K, Hunt M. Validity and reliability of the Nintendo Wii balance board for assessment of standing balance. Gait & Posture. 2010;31:307–10. CrossRef
TH MC Jr, Castro VM, Cagan A, Roberson AM, Perlis RH. Validation of a risk stratification tool for fall-related injury in a state-wide cohort. BMJ Open. 2017;7:e012189. CrossRef
Fabre JM, Ellis R, Kosma M, Wood RH. Falls risk factors and a compendium of falls risk screening instruments. J Geriatr Phys Ther. 2010;33:184–97. PubMed
Gomez F, Wu YY, Auais M, Vafaei A, Zunzunegui MV. A simple algorithm to predict falls in primary care patients aged 65 to 74 years: the international mobility in aging study. J Am Med Dir Assoc. 2017; doi: 10.1016/j.jamda.2017.03.021.
Gomez JF, Curcio CL, Alvarado B, Zunzunegui MV, Guralnik J. Validity and reliability of the short physical performance battery (SPPB): a pilot study on mobility in the Colombian Andes. Colomb Med (Cali). 2013;44:165–71.
World Health Organization: Definition of a Fall. http://www.who.int/mediacentre/factsheets/fs344/en/ (2016). Accessed 02 Sep 2016.
Harrell FE Jr. Regression modeling strategies: with applications to linear models, logistic and ordinal regression, and survival analysis. 3rd ed. New York: Springer; 2015. CrossRef
Harrell Jr FE: Rms: Regression modeling strategies. R package version 4.4–1. Http://cran.R-project.Org/package=rms (2015). Accessed 02 Feb 2016.
Filiatrault J, Belley A-M, Laforest S, Gauvin L, Richard L, Desrosiers J, et al. Fear of falling among seniors: a target to consider in occupational and physical therapy practice? Phys Occup Ther in Geriatr. 2013;31:197–213. CrossRef
- Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study
Ross Allan Clark
David B. Matcher
Edwin Choon-Wyn Lim
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II