Falls and catastrophic thoughts about falls predict mobility restriction in community-dwelling older people: A structural equation modelling approach.
OBJECTIVE
How and when concerns about falls emerge is not yet completely known, because these concerns are present in both people with and without a falls history. The aim of this study was to investigate the role of catastrophic beliefs about falls and previous falls in the development of concerns about falls and resulting mobility restrictions (MR).


METHODS
Within a cross-sectional design, 896 older people (mean age 76.2 +/- 4.7) living independently in the community completed a battery of questionnaires. Self-report data was gathered on previous falls, catastrophic beliefs about consequences of a fall (Catastrophizing About Falls Scale), concerns about falls (modified Falls Efficacy Scale) and mobility restrictions during daily life (Sickness Impact Profile 68).


RESULTS
Using structural equation modelling, we found that the number of falls in the previous year was not directly related to mobility restrictions in daily life, but via an increase of concerns about falls. Also catastrophic beliefs about the consequences of falls were related to concerns about falls and to mobility restrictions. Goodness-of-fit indices revealed that the presented model had an acceptable fit. Alternative models resulted in lesser-fit indices.


CONCLUSIONS
Both previous falls and catastrophic beliefs about falls are unique and independent predictors of concerns about falls and, subsequently, of mobility restrictions. A cognitive-behavioural perspective upon mobility restrictions may provide important additional components for treatment and prevention of excessive concerns about falls in older people.
Delbaere
Kim
K
Falls and Balance Research Group, Prince of Wales Medical Research Institute, University of New South Wales, Randwick, NSW 2031, Sydney, Australia. K.Delbaere@powmri.edu.au
Crombez
Geert
G
van Haastregt
Jolanda C M
JC
Vlaeyen
Johan W S
JW
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003625:Data Collection; D005239:Fear / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015233:Models, Statistical; D009426:Netherlands; D016032:Randomized Controlled Trials as Topic; D012112:Residential Facilities; D012649:Self Concept; D011795:Surveys and Questionnaires