Rocky Mountain University of Health Professions, Provo, Utah.
University of Puget Sound School of Physical Therapy, Tacoma, Washington.
J Geriatr Phys Ther. 2023;46(1):82-89. doi: 10.1519/JPT.0000000000000349. Epub 2022 May 9.
Fear of falling (FoF) is highly prevalent in community-dwelling older adults and is associated with low health-related quality of life (QoL). Low QoL is associated with increased health care utilization and is a predictor of future falls, but few studies have examined the relationship between high-level balance and dynamic gait performance and QoL in community-dwelling older adults. The purpose of this cross-sectional study was to determine whether there is a relationship between FoF avoidance behaviors, balance confidence, performance on measures of high-level mobility, and QoL in community-dwelling older adults. The secondary purpose was to determine whether older adults who fall have a different QoL than older adults who have not fallen in the past year.
Eighty-nine community-dwelling older adults (76.33 ± 6.84 years, 54 female, 34 fallers) completed the World Health Organization Quality of Life-BREF (WHOQOL-BREF), Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behavior Questionnaire (FFABQ), Functional Gait Assessment (FGA), and Community Balance and Mobility Scale (CB&M). Correlation and multiple regression analyses were calculated to determine the relationship between the outcome measures and domains on the WHOQOL-BREF.
Significant correlations were observed between the WHOQOL-BREF physical health domain and the ABC, FFABQ, FGA, and CB&M (ρ= 0.524, -0.509, 0.348, and r = 0.423, respectively), the WHOQOL-BREF psychological domain and the ABC (ρ= 0.284) and FFABQ (ρ=-0.384), and the WHOQOL-BREF environment domain and the ABC (ρ= 0.343) and FFABQ (ρ=-0.406). No correlations were found between WHOQOL-BREF domain scores and a history of falls.
Performance-based outcome measures that measure high-level mobility such as the CB&M and FGA, and patient-reported outcome measures for balance confidence and FoF avoidance behavior such as the ABC and FFABQ, are correlated with the physical health QoL domain on the WHOQOL-BREF. The ABC and FFABQ are correlated with psychological and environment QoL. Fall history was not correlated with QoL. Interventions to decrease FoF or improve high-level mobility may improve QoL in community-dwelling older adults.
跌倒恐惧（Fear of falling，FoF）在社区居住的老年人中非常普遍，与健康相关的生活质量（Quality of life，QoL）较低有关。生活质量低与医疗保健利用率增加有关，也是未来跌倒的预测因素，但很少有研究检查社区居住的老年人中高水平平衡和动态步态表现与 QoL 之间的关系。本横断面研究的目的是确定社区居住的老年人中 FoF 回避行为、平衡信心、高水平移动能力测量结果与 QoL 之间是否存在关系。次要目的是确定过去一年中跌倒的老年人与未跌倒的老年人的 QoL 是否不同。
89 名社区居住的老年人（76.33 ± 6.84 岁，54 名女性，34 名跌倒者）完成了世界卫生组织生活质量简表（World Health Organization Quality of Life-BREF，WHOQOL-BREF）、活动特异性平衡信心量表（Activities-specific Balance Confidence Scale，ABC）、跌倒恐惧回避行为问卷（Fear of Falling Avoidance Behavior Questionnaire，FFABQ）、功能性步态评估（Functional Gait Assessment，FGA）和社区平衡与移动量表（Community Balance and Mobility Scale，CB&M）。进行相关性和多元回归分析，以确定 WHOQOL-BREF 各量表之间的关系。
观察到 WHOQOL-BREF 身体健康领域与 ABC、FFABQ、FGA 和 CB&M 之间存在显著相关性（ρ=0.524、-0.509、0.348 和 r=0.423），WHOQOL-BREF 心理领域与 ABC（ρ=0.284）和 FFABQ（ρ=-0.384）之间存在相关性，WHOQOL-BREF 环境领域与 ABC（ρ=0.343）和 FFABQ（ρ=-0.406）之间存在相关性。WHOQOL-BREF 各领域得分与跌倒史之间无相关性。
衡量高水平移动能力的基于表现的结果测量，如 CB&M 和 FGA，以及衡量平衡信心和 FoF 回避行为的患者报告结果测量，如 ABC 和 FFABQ，与 WHOQOL-BREF 的身体健康领域相关。ABC 和 FFABQ 与心理和环境健康相关。跌倒史与 QoL 无关。减少 FoF 或改善高水平移动能力的干预措施可能会提高社区居住的老年人的生活质量。
