title: The geriatric depression scale and the timed up and go test predict fear of falling in community-dwelling elderly women with type 2 diabetes mellitus: a cross-sectional study.
abstract: BACKGROUND
  Fear of falling is a common and potentially disabling problem among older adults. However, little is known about this condition in older adults with diabetes mellitus. The aims of this study were to investigate the impact of the fear of falling on clinical, functional and gait variables in older women with type 2 diabetes and to identify which variables could predict the fear of falling in this population.
  
  
  METHODS
  Ninety-nine community-dwelling older women with type 2 diabetes (aged 65 to 89 years) were stratified in two groups based on their Falls Efficacy Scale-International score. Participants with a score < 23 were assigned to the group without the fear of falling (n = 50) and those with a score ≥ 23 were assigned to the group with the fear of falling (n = 49). Clinical data included demographics, anthropometrics, number of diseases and medications, physical activity level, fall history, frailty level, cognition, depressive symptoms, fasting glucose level and disease duration. Functional measures included the Timed Up and Go test (TUG), the five times sit-to-stand test (5-STS) and handgrip strength. Gait parameters were obtained using the GAITRite® system.
  
  
  RESULTS
  Participants with a fear of falling were frailer and presented more depressive symptoms and worse performance on the TUG and 5-STS tests compared with those without a fear of falling. The group with the fear of falling also walked with a lower velocity, cadence and step length and increased step time and swing time variability. The multivariate regression analysis showed that the likelihood of having a fear of falling increased 1.34 times (OR 1.34, 95 % CI 1.11-1.61) for a one-point increase in the Geriatric Depression Scale (GDS-15) score and 1.36 times (OR 1.36, 95 % CI 1.07-1.73) for each second of increase in the TUG performance.
  
  
  CONCLUSIONS
  The fear of falling in community-dwelling older women with type 2 diabetes mellitus is associated with frailty, depressive symptoms and dynamic balance, functional mobility and gait deficits. Furthermore, both the GDS-15 and the TUG test predict a fear of falling in this population. Therefore, these instruments should be considered during the assessment of diabetic older women with fear of falling.
authors.affiliation: Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil. brunosouzamoreira@gmail.com.
authors.forename: Bruno de Souza
authors.initials: Bde S
authors.lastname: Moreira
authors.affiliation: Centro Universitário Estácio, Physical Therapy Course, Minas Gerais, Belo Horizonte, Brazil. danielacruzanjos@gmail.com.
authors.forename: Daniela Maria da Cruz
authors.initials: DM
authors.lastname: Dos Anjos
authors.affiliation: Nursing School, Physical Therapy Course, Universidade Federal de Alfenas, Minas Gerais, Alfenas, Brazil. daniele.sirineu@gmail.com.
authors.forename: Daniele Sirineu
authors.initials: DS
authors.lastname: Pereira
authors.affiliation: Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil. sampaioufmg@gmail.com.|Department of Physical Therapy, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil. sampaioufmg@gmail.com.
authors.forename: Rosana Ferreira
authors.initials: RF
authors.lastname: Sampaio
authors.affiliation: Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil. leanismp.bh@terra.com.br.
authors.forename: Leani Souza Máximo
authors.initials: LS
authors.lastname: Pereira
authors.affiliation: Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil. rcorreadias8@gmail.com.
authors.forename: Rosângela Corrêa
authors.initials: RC
authors.lastname: Dias
authors.affiliation: Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil. renata.kirkwood@gmail.com.
authors.forename: Renata Noce
authors.initials: RN
authors.lastname: Kirkwood
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D003071:Cognition / Q000502:physiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D005239:Fear / Q000523:psychology*; D005260:Female; D005684:Gait / Q000502:physiology; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D011379:Prognosis