Kempen Gertrudis I J M, van Haastregt Jolanda C M, McKee Kevin J, Delbaere Kim, Zijlstra G A Rixt
School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
BMC Public Health. 2009 Jun 2;9:170. doi: 10.1186/1471-2458-9-170.
Fear of falling and avoidance of activity are common in old age and are suggested to be (public) health problems of equal importance to falls. Earlier studies of correlates of fear of falling and avoidance of activity did hardly differentiate between severe and mild levels of fear of falling and avoidance of activity which may be relevant from clinical point of view. Furthermore, most studies focused only on socio-demographics and/or health-related variables and hardly incorporated an extensive range of potential correlates of fear of falling including psychosocial variables. This study analyzes the univariate and multivariate associations between five socio-demographic, seven health-related and six psychosocial variables and levels of fear of falling and avoidance of activity in older persons who avoid activity due to fear of falling.
Cross-sectional study in 540 community-living older people aged > or = 70 years with at least mild fear of falling and avoidance of activity. Chi-squares, t-tests and logistics regression analyses were performed to study the associations between the selected correlates and both outcomes.
Old age, female sex, limitations in activity of daily living, impaired vision, poor perceived health, chronic morbidity, falls, low general self-efficacy, low mastery, loneliness, feelings of anxiety and symptoms of depression were identified as univariate correlates of severe fear of falling and avoidance of activity. Female sex, limitations in activity of daily living and one or more falls in the previous six months correlated independently with severe fear of falling. Higher age and limitations in activity of daily living correlated independently with severe avoidance of activity.
Psychosocial variables did not contribute independently to the difference between mild and severe fear of falling and to the difference between mild and severe avoidance of activity due to fear of falling. Although knowledge about the unique associations of specific variables with levels of severe fear of falling and avoidance of activity is of interest for theoretical reasons, knowledge of univariate association may also help to specify the concepts for developing interventions and programmes to reduce fear of falling and avoidance of activity in old age, particularly in their early stages of development.
害怕跌倒和回避活动在老年人中很常见，被认为是与跌倒同等重要的（公共）卫生问题。早期关于害怕跌倒和回避活动相关因素的研究几乎没有区分严重和轻度的害怕跌倒及回避活动程度，而从临床角度来看这可能是相关的。此外，大多数研究仅关注社会人口统计学和/或与健康相关的变量，几乎没有纳入广泛的潜在跌倒恐惧相关因素，包括心理社会变量。本研究分析了五个社会人口统计学、七个与健康相关以及六个心理社会变量与因害怕跌倒而回避活动的老年人的跌倒恐惧程度和回避活动水平之间的单变量和多变量关联。
对540名年龄≥70岁、至少有轻度跌倒恐惧和回避活动的社区居住老年人进行横断面研究。进行卡方检验、t检验和逻辑回归分析，以研究选定相关因素与两种结果之间的关联。
老年、女性、日常生活活动受限、视力受损、自我感觉健康不佳、慢性病、跌倒、一般自我效能感低、掌控感低、孤独、焦虑情绪和抑郁症状被确定为严重害怕跌倒和回避活动的单变量相关因素。女性、日常生活活动受限以及在过去六个月内有一次或多次跌倒与严重害怕跌倒独立相关。年龄较大和日常生活活动受限与严重回避活动独立相关。
心理社会变量并未独立导致轻度和严重跌倒恐惧之间以及因害怕跌倒而导致的轻度和严重回避活动之间的差异。尽管出于理论原因，了解特定变量与严重跌倒恐惧程度和回避活动水平的独特关联很有意义，但单变量关联的知识也可能有助于明确制定干预措施和计划的概念，以减少老年人的跌倒恐惧和回避活动，特别是在其发展的早期阶段。
