title: Fear of Falling after Hip Fracture: Prevalence, Course, and Relationship with One-Year Functional Recovery.
abstract: The effect of fear of falling (FoF) on recovery 1 year after hip fracture is not well known. Furthermore, the potential influence of premorbid function has not been explored. We aimed to describe rates of FoF after hip fracture, to assess the association of FoF with functional recovery 1 year post-fracture, and to evaluate the potential moderating effect of premorbid function on the relationship between FoF and functional recovery.
  
  
  
  Secondary analysis of data from a prospective, longitudinal observational study to assess genetic factors influencing functional and psychological outcomes after hip fracture over 52 weeks.
  
  
  
  Eight area hospitals in St. Louis, MO.
  
  
  
  241 cognitively intact individuals 60 years of age or older requiring surgical repair for hip fracture.
  
  
  
  Fear of falling was measured by the short Falls Efficacy Scale-International 4 and 12 weeks post-fracture. The primary outcome was probability of full recovery 52 weeks post-fracture assessed with the Functional Recovery Score.
  
  
  
  High rates of FoF were seen at 4 (60.5%) and 12 weeks (47.0%) post-fracture. Week 12 FoF was associated with lower odds of recovery for those with high function pre-fracture (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.72, 0.93), but not for those with impaired activities of daily living performance (OR: 1.04, 95% CI: 0.91, 1.19).
  
  
  
  Fear of falling is common after hip fracture and is associated with poorer functional recovery 1 year after fracture, particularly in patients with high premorbid function. Fear of falling is a modifiable problem that represents a potential target for interventions to improve functional outcomes after hip fracture.
authors.affiliation: SDSU/UCSD Joint Doctoral Program in Clinical PsychologySan Diego, CA.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Bower
authors.affiliation: the VA San Diego Healthcare System, and Department of Psychiatry University of California, San Diego, CA. Electronic address: jwetherell@ucsd.edu.
authors.forename: Julie Loebach
authors.initials: JL
authors.lastname: Wetherell
authors.affiliation: Department of Psychology, University of Southern California, Los Angeles, CA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Petkus
authors.affiliation: Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO.
authors.forename: Kerri S
authors.initials: KS
authors.lastname: Rawson
authors.affiliation: Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005239:Fear; D005260:Female; D006620:Hip Fractures / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020127:Recovery of Function
keywords: Falls Efficacy Scale International; Functional Recovery Score; fall-related self-efficacy; fear of falling; hip fracture