Fear of falling in new long-term care enrollees.
OBJECTIVE
To measure the prevalence of fear of falling in older adults at the time of long- term care (LTC) enrollment and identify potentially treatable risk factors for low fall related self-efficacy.


METHODS
Prospective cohort study.


METHODS
Three LTC programs in Upstate New York.


METHODS
112 new enrollees in LTC, aged 55 or older, who passed a cognitive screen.


METHODS
Self-reported falls, the falls efficacy scale (FES), medical conditions, the short geriatric depression scale, and physical performance measures (Berg balance scale, hip flexor, knee extensor and grip strength, gait speed and a six-minute walk).


RESULTS
Of the 54 subjects (48.2%) who reported fear of falling, 41 (75.9%) reported activity modification secondary to fear. Fearful subjects were more likely to be female (P = .003), report low back pain (P = .030) and lower extremity arthritis (P = .037). Fearful subjects were weaker at the hip (P < .001) and knee (P = .001), and had shorter six-minute walk distances. Subjects with better FES scores had better Berg scores (P < .001), had greater hip and knee strength, had faster gait speeds and walked further in six minutes (P < .001, P = .006, P = .001 and P = .001 respectively). Subjects with low FES scores and fearful subjects were more likely to have depressive symptoms (P = .003, P = .044, respectively).


CONCLUSIONS
Falls and fear of falling are more common in new LTC enrollees than in previously described community dwelling and SNF cohorts. Attention to associated characteristics like depression, arthritis, low back pain and lower extremity weakness may identify opportunities to reduce fear and improve patient safety during this transitional period.
Gillespie
Suzanne M
SM
Division of Geriatrics/Aging, University of Rochester School of Medicine and Dentistry, Monroe Community Hospital, Rochester, NY, USA. Suzanne_Gillespie@urmc.rochester.edu
Friedman
Susan M
SM
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000453:epidemiology; D001168:Arthritis / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005239:Fear; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data*; D017116:Low Back Pain / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D020377:Self Efficacy; D017678:Sex Distribution