Kressig R W, Wolf S L, Sattin R W, O'Grady M, Greenspan A, Curns A, Kutner M
Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
J Am Geriatr Soc. 2001 Nov;49(11):1456-62. doi: 10.1046/j.1532-5415.2001.4911237.x.
To determine, in a cohort of older individuals transitioning to frailty (defined by Speechley and Tinetti, 1991) who have previously fallen, whether there are significant associations between demographic, functional, and behavioral characteristics and activity-related fear of falling, using both the Falls Efficacy Scale (FES) and the Activities-Specific Balance Confidence Scale (ABC).
Baseline cross-sectional analysis in a prospective cohort intervention study.
Twenty independent senior living facilities in Atlanta.
Seventeen male and 270 female subjects (n = 287), age 70 and older (mean +/- standard deviation, 80.9 +/- 6.2), with Mini-Mental State Examination score > or = 24, transitioning to frailty, ambulatory (with or without assistive device), medically stable, and having fallen in the past year.
Activity-related fear of falling was evaluated with the FES and ABC Scale. Because of the comparable data derived from each scale, associations with functional measures-related analyses were expressed using the latter. Depression was measured by Center for Epidemiological Studies Depression Scale. Functional measurements included timed 360 degrees turn, functional reach test, timed 10-meter walk test, single limb stands, picking up an object, and three chair stands.
No statistically significant association was found between activity-related fear of falling and age. For the proposed activities, about half (ABC, 48.1%; FES, 50.1%) of the subjects were concerned about falling or showed lack of confidence in controlling their balance. A statistically significant inverse correlation was found between FES and ABC (r = -0.65; P < .001). African-American subjects showed more activity-related fear of falling than did Caucasians (odds ratio (OR): 2.7 for ABC; 2.1 for FES). Fearful individuals were more likely to be depressed and more likely to report the use of a walking aid than were nonfearful individuals. Fear of falling was significantly correlated to all of the functional measurements (P < .05). In a multivariable logistic regression model, depression, using a walking-aid, slow gait speed, and being an African-American were directly related to being more fearful of falling.
Activity-related fear of falling was present in almost half of this sample of older adults transitioning to frailty. The significant association of activity-related fear of falling with demographic, functional, and behavioral characteristics emphasizes the need for multidimensional intervention strategies to lessen activity-related fear of falling in this population.
在一组向衰弱转变（由Speechley和Tinetti于1991年定义）且既往有跌倒史的老年人中，使用跌倒效能量表（FES）和特定活动平衡信心量表（ABC），确定人口统计学、功能和行为特征与与活动相关的跌倒恐惧之间是否存在显著关联。
前瞻性队列干预研究中的基线横断面分析。
亚特兰大的20家独立老年生活设施。
17名男性和270名女性受试者（n = 287），年龄70岁及以上（平均±标准差，80.9±6.2），简易精神状态检查表得分≥24，向衰弱转变，能行走（有或无辅助设备），医学状况稳定，且在过去一年中有过跌倒。
使用FES和ABC量表评估与活动相关的跌倒恐惧。由于每个量表得出的数据具有可比性，因此与功能测量相关分析的关联使用后者表示。用流行病学研究中心抑郁量表测量抑郁。功能测量包括定时360度转身、功能性伸展测试、定时10米步行测试、单腿站立、捡起物品和三次从椅子上站起。
未发现与活动相关的跌倒恐惧和年龄之间存在统计学显著关联。对于所提出的活动，约一半（ABC量表为48.1%；FES量表为50.1%）的受试者担心跌倒或对控制平衡缺乏信心。发现FES和ABC之间存在统计学显著的负相关（r = -0.65；P <.001）。非裔美国受试者比白人受试者表现出更多与活动相关的跌倒恐惧（优势比（OR）：ABC量表为2.7；FES量表为2.1）。与不恐惧的个体相比，恐惧的个体更可能抑郁，且更可能报告使用助行器。跌倒恐惧与所有功能测量均显著相关（P <.05）。在多变量逻辑回归模型中，抑郁、使用助行器、步态速度慢和非裔美国人身份与更害怕跌倒直接相关。
在这组向衰弱转变的老年人样本中，近一半存在与活动相关的跌倒恐惧。与活动相关的跌倒恐惧与人口统计学、功能和行为特征的显著关联强调了需要采取多维干预策略来减轻该人群中与活动相关的跌倒恐惧。
