When fear takes over: how fear of falling affects functional ability in older adult fallers
Keywords:
fear of falling, falls efficacy scale-international, functional ability, balance, mobility, older adultsAbstract
Objective: This cross-sectional observational study aimed to investigate the association between fear of falling (FOF) and functional ability in low-concern fallers and high-concern fallers.
Materials and Methods: Participants aged 65–80 years with a history of falls were classified into two groups based on their Falls Efficacy Scale-International (FES-I) scores: low-concern fallers (FES-I ≤ 27) and high-concern fallers (FES-I > 27). Functional ability was assessed using the Timed Up and Go (TUG) test and the Chair Stand Test (CST). The Mann-Whitney U test was used to compare FES-I, TUG, and CST scores between the two groups. Correlation analysis was performed to explore the relationship between FES-I and TUG, as well as between FES-I and CST.
Results: High-concern fallers had significantly higher FES-I scores (z = -4.756, p < 0.001) and performed significantly fewer repetitions on the CST (z = -2.077, p = 0.038) compared to low-concern fallers. However, no significant difference in TUG scores was observed between the groups (z = -0.423, p = 0.673). Furthermore, there was a significant negative correlation
between FES-I scores and CST performance (r(30) = -0.389, p = 0.028), but no significant correlation was found between FES-I and TUG (r(30) = 0.083, p = 0.650).
Conclusion: A greater FOF is associated with reduced lower limb strength or sit-to-stand performance (as indicated by CST), rather than with general mobility (as indicated by TUG). These findings suggest that interventions targeting both FOF and sit-to-stand performance may be beneficial for older adult fallers.
References
Kendrick D, Kumar A, Carpenter H, Zijlstra GAR, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. Cochrane Database of Systematic Reviews. 2014(11).
Wu K-Y, Chen D-R, Chan C-C, Yeh Y-P, Chen H-H. Fear of falling as a mediator in the association between social frailty and health-related quality of life in community-dwelling older adults. BMC Geriatrics. 2023;23(1):421.
Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. Journal of Gerontology. 1990;45(6):P239-P43.
Lee TH, Kim W. Is fear of falling and the associated restrictions in daily activity related to depressive symptoms in older adults?. Psychogeriatrics. 2021;21(3):304-10.
Lee S, Hong G-RS. The predictive relationship between factors related to fear of falling and mortality among community-dwelling older adults in Korea: analysis of the Korean longitudinal study of aging from 2006 to 2014. Aging & Mental Health. 2020;24(12):1999-2005.
Ma W, Liang X, Wang H, Wen Z, Liu L, Fan L, et al. Association between fear of falling and mortality in middle-aged and older adults: a systematic review and meta-analysis. Geriatric Nursing. 2024;59:113-20.
Delbaere K, Close JC, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age and Ageing. 2010;39(2):210-6.
Schoene D, Heller C, Aung YN, Sieber CC, Kemmler W, Freiberger E. A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls?. Clinical Interventions in Aging. 2019;14:701-19.
Dolan HR, Pool N. Overcoming waves of helplessness: The meaning of experiencing fear of falling. Geriatric Nursing. 2023;52:40-7.
Hemrungrojn S, Tangwongchai S, Charoenboon T, Panasawat M, Supasitthumrong T, Chaipresertsud P, et al. Use of the Montreal Cognitive Assessment Thai version to discriminate amnestic mild cognitive impairment from Alzheimer's disease and healthy controls: machine learning results. Dementia and Geriatric Cognitive Disorders. 2021;50(2):183-94.
Montero-Odasso M, van der Velde N, Alexander NB, Becker C, Blain H, Camicioli R, et al. New horizons in falls prevention and management for older adults: a global initiative. Age and Ageing. 2021;50(5):1499-507.
Dewan N, MacDermid JC. Fall Efficacy Scale-International (FES-I). Journal of Physiotherapy. 2014;60(1):60.
Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Research Quarterly for Exercise and Sport. 1999;70(2):113-9.
Podsiadlo D, Richardson S. The Timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991;39(2):142-8.
Narici MV. Neuromuscular deconditioning with disuse: should we live more on our nerves?. The Journal of Physiology. 2017;595(13):4127.
Tucker MG, Kavanagh JJ, Morrison S, Barrett RS. Differences in rapid initiation and termination of voluntary postural sway associated with ageing and falls-risk. Journal of Motor Behavior. 2010;42(5):277-87.
Pieterse AJ, Luttikhold TB, de Laat K, Bloem BR, van Engelen BG, Munneke M. Falls in patients with neuromuscular disorders. Journal of the Neurological Sciences. 2006;251(1):87-90.
Pieruccini-Faria F, Montero-Odasso M. Obstacle negotiation, gait variability, and risk of falling: results from the “gait and brain study”. The Journals of Gerontology: Series A. 2018;74(9):1422-8.
Makino K, Makizako H, Doi T, Tsutsumimoto K, Hotta R, Nakakubo S, et al. Fear of falling and gait parameters in older adults with and without fall history. Geriatrics & Gerontology International. 2017;17(12):2455-9.
Suri A, Hubbard ZL, VanSwearingen J, Torres-Oviedo G, Brach JS, Redfern MS, et al. Fear of falling in community-dwelling older adults: What their gait acceleration pattern reveals. Computer Methods and Programs in Biomedicine. 2024;244:108001.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2025 The 11th International Physical Therapy Research Symposium 2025 (IPTRS 2025)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
