title: Fear of falling and mortality among community-dwelling older adults in the Shih-Pai study in Taiwan: A longitudinal follow-up study.
abstract: OBJECTIVE
  Little is known about the association between fear of falling (FOF) and the risk of mortality. The aim of the present study was to investigate the association between FOF and mortality among community-dwelling older adults.
  
  
  METHODS
  A total of 3814 older adults aged 65 years and older living in the Shih-Pai area in Taiwan participated in this 7-year follow-up longitudinal study. A structured questionnaire was used to record participants' FOF, history of falling, demographic characteristics, medical conditions, history of insomnia, depression symptoms and subjective health from 1999 to 2002. Follow-up all-cause mortality data were obtained from the National Death Registry of the Department of Health to identify the occurrence of deaths from the initial interview through to 31 December 2008.
  
  
  RESULTS
  At the baseline assessment, the mean age of the participants was 73.8 ± 5.8 years, 56.4% were men and 53.4% had FOF. Cox regression showed that participants with FOF had an increased risk of mortality (aHR 1.16, 95% CI 1.02-1.33) after adjusting for sex, history of falling, age, body mass index, marital status, education level, smoking status, alcohol use, living status, chronic condition, depression and subjective health. Furthermore, FOF was a significant risk factor for male participants (aHR 1.17, 95% CI 1.00-1.38), but had a marginal risk for female participants (aHR 1.24, 95% CI 0.95-1.60) after adjusting for other risk factors, as in the full model except for sex.
  
  
  CONCLUSIONS
  The findings of the present study suggest that FOF is a significant risk factor of mortality, especially in older male adults. Further research on the mechanism and effects of fear of falling on mortality is necessary. Geriatr Gerontol Int 2017; 17: 2216-2223.
authors.affiliation: Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hsiao-Ting
authors.initials: HT
authors.lastname: Chang
authors.affiliation: Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hsi-Chung
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000058:Accidental Falls; D000368:Aged; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000639:trends*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: anxiety; fear of falling; mortality; older adults; ptophobia