title: Perceived Fall Risk and Functional Decline: Gender Differences in Patient's Willingness to Discuss Fall Risk, Fall History, or to Have a Home Safety Evaluation.
abstract: The CDC reports that among older adults, falls are the leading cause of injury-related death and rates of fall-related fractures among older women are twice those of men. We set out to 1) determine patient perceptions (analyzed by gender) about their perceived fall risk compared to their actual risk for functional decline and death and 2) to report their comfort level in discussing their fall history or a home safety plan with their provider. Elders who presented to the Emergency Department (ED†) were surveyed. The survey included demographics, the Falls Efficacy Scale (FES) and the Vulnerable Elders Survey (VES); both validated surveys measuring fall concern and functional decline. Females had higher FES scores (mean 12.3, SD 5.9) than males (mean 9.7, SD 5.9 p = .007) in the 146 surveys analyzed. Females were more likely to report an increased fear of falling, and almost three times more likely to have a VES score of 3 or greater than males (OR = 2.86, 95% CI: 1.17-7.00, p = .02). A strong correlation was observed between FES and VES scores (r = 0.80, p < .001). No difference in correlation was observed between males and females, p = .26. Participants (77 percent) reported they would be comfortable discussing their fall risk with a provider; there was no difference between genders (p = .57). In this study, irrespective of gender, there appears to be a high association between subjects' perceived fall risk and risk for functional decline and death. The majority of patients are likely willing to discuss their fall risk with their provider. These findings may suggest a meaningful opportunity for fall risk mitigation in this setting.
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Emergency Medicine.
authors.forename: Marna Rayl
authors.initials: MR
authors.lastname: Greenberg
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Family practice.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Moore
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Emergency Medicine.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nguyen
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Family practice.
authors.forename: Brian
authors.initials: B
authors.lastname: Stello
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Family practice.
authors.forename: Arnold
authors.initials: A
authors.lastname: Goldberg
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Surgery.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Barraco
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Emergency Medicine.
authors.forename: Bernadette G
authors.initials: BG
authors.lastname: Porter
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Emergency Medicine.
authors.forename: Anita
authors.initials: A
authors.lastname: Kurt
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Emergency Medicine.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Dusza
authors.affiliation: Lehigh Valley Hospital and Health Network/USF Morsani College of Medicine, Department of Emergency Medicine.
authors.forename: Bryan G
authors.initials: BG
authors.lastname: Kane
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010465:Perception / Q000502:physiology*; D012307:Risk Factors
keywords: Emergency Department; Fall risk; Fear of Falling; Mechanical Fall