title: Effect of fall-related concerns on physical, mental, and social function in community-dwelling older adults: a prospective cohort study.
abstract: OBJECTIVE
  To determine the effect of fall-related concerns on physical, mental, and social function.
  
  
  METHODS
  Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial).
  
  
  METHODS
  Two municipalities in the south of the Netherlands.
  
  
  METHODS
  Community-dwelling older adults (N = 260).
  
  
  METHODS
  Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline.
  
  
  RESULTS
  At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months.
  
  
  CONCLUSIONS
  Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls.
authors.affiliation: Department of Health Services Research, Maastricht University, Maastricht, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: van der Meulen
authors.forename: G A Rixt
authors.initials: GA
authors.lastname: Zijlstra
authors.forename: Ton
authors.initials: T
authors.lastname: Ambergen
authors.forename: Gertrudis I J M
authors.initials: GI
authors.lastname: Kempen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000523:psychology; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D012111:Residence Characteristics; D012944:Social Support
keywords: aged; community-dwelling; concerns about falls; daily functioning; prospective studies