Fear of falling is common in patients with type 2 diabetes and is associated with increased risk of falls.
OBJECTIVE
fear of falling is an important falls-related symptom that has received little attention in studies of falls risk in older adults with type 2 diabetes.


METHODS
matched pairs of participants with diabetes or with normoglycaemia (n = 186 per group) recruited from a community-based survey underwent an assessment of fear of falling and associated falls risk factors. Multivariate methods examined associations between fear of falling and risk factors for history of recent falls.


RESULTS
compared with the normoglycaemic participants, those with diabetes had worse mobility (slow timed Up and Go test times: 16.2 versus 4.9%, P < 0.01), more fear of falling (24.2 versus 15.1%, P < 0.05) and more activity restriction from fear of falling (indoors: 14.0 versus 4.8%, P = 0.006), but there was no increase in reported recent falls. In the combined sample, a history of recent falls was negatively associated with fear-related limitation of outdoor activities (odds ratio (95% confidence interval): 0.30 (0.15-0.58), P < 0.001) and positively associated with age (1.65 (1.20-2.28) per 10-year increase, P = 0.002) and use of antidepressants (2.14 (1.02-4.50, P = 0.044). The frequency of falls in those with recurrent falls was negatively associated with measures of balance.


CONCLUSIONS
type 2 diabetes is associated with increased fear of falling and fear-associated activity restriction, and this modifies the risk of falls even in the face of increased falls risk factors including worse mobility. Future studies of falls in diabetes need to consider that fear of falling is an important modifier of the relationship between risk factors and falls.
School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, Western Australia 6959, Australia.
David
D
Bruce
Busselton Population Medical Research Institute, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Michael
M
Hunter
School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, Western Australia 6959, Australia.
Kirsten
K
Peters
School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, Western Australia 6959, Australia.
Timothy
T
Davis
School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, Western Australia 6959, Australia.
Wendy
W
Davis
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D005239:Fear; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D004856:Postural Balance / Q000502:physiology*; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology
diabetes; falls; mobility; older people