Meyer Marco, Arnold Andreas, Stein Thomas, Niemöller Ulrich, Tanislav Christian
Department of Geriatrics, Diakonie Hospital Jung Stilling Siegen, Wichernstrasse 40, 57074 Siegen, Germany.
J Clin Med. 2025 Jun 19;14(12):4366. doi: 10.3390/jcm14124366.
: This prospective observational study aimed to investigate the prevalence, progression, and clinical factors associated with fear of falling (FOF) in older adults hospitalized for comprehensive geriatric care (CGC). : FOF was assessed using two measures: a single-item question (SIQ) asking, "Are you currently afraid of falling?" with responses scored as (0) not at all; (1) a little; (2) quite a bit; (3) very much, and the Falls Efficacy Scale International (FES-I). FES-I scores were categorized into low (FES-I 16-19), moderate (FES-I 20-27), and high (FES-I 28-64) concerns about falling. FOF scores were analyzed in relation to patients' characteristics and functional performance. : A total of 103 patients were included in the final analysis (mean age: 81.9 years, 64.1% female). Upon hospital admission, 74.8% of patients reported FOF (SIQ ≥ 1), with no significant change at discharge (73.8%, > 0.999). Patients' FES-I scores indicated high concerns about falling, with only slight improvements following CGC. The median FES-I score upon admission decreased from 31 (IQR: 23.5-40) to 30 (IQR: 23.5-38) at discharge ( < 0.001). Logistic regression analysis revealed that persistently high concerns about falling (FES-I 28-64) after undergoing CGC were associated with depressive symptoms (Geriatric Depression Scale score ≥ 6; OR: 3.61, 95% CI: 1.30-10.04) and a diagnosis of heart failure (OR: 3.63, 95% CI: 1.30-10.11). Patients' scores in the Barthel Index, Timed Up and Go Test, and Tinetti Test improved after treatment, but these changes (Δ) did not show a significant correlation with those in the FES-I or SIQ. : Our findings demonstrate that FOF is highly prevalent among older adults hospitalized for CGC and persists with only minimal improvement following treatment. Persistently high concerns about falling even after completing CGC were associated with depressive symptoms and a diagnosis of heart failure. These results highlight the potential for more targeted interventions within CGC to more effectively address FOF in this vulnerable population.
这项前瞻性观察性研究旨在调查因综合老年护理（CGC）住院的老年人中害怕跌倒（FOF）的患病率、进展情况以及相关临床因素。FOF通过两种测量方法进行评估：一个单项问题（SIQ），询问“您目前是否害怕跌倒？”，回答分为（0）一点也不；（1）有点；（2）相当多；（3）非常害怕，以及国际跌倒效能量表（FES - I）。FES - I得分被分为对跌倒的低（FES - I 16 - 19）、中（FES - I 20 - 27）和高（FES - I 28 - 64）担忧程度。对FOF得分与患者特征和功能表现进行了分析。最终分析纳入了103例患者（平均年龄：81.9岁，64.1%为女性）。入院时，74.8%的患者报告有FOF（SIQ≥1），出院时无显著变化（73.8%，P>0.999）。患者的FES - I得分表明对跌倒高度担忧，CGC治疗后仅有轻微改善。入院时FES - I得分中位数从31（四分位间距：23.5 - 40）降至出院时的30（四分位间距：23.5 - 38）（P<0.001）。逻辑回归分析显示，接受CGC治疗后对跌倒持续高度担忧（FES - I 28 - 64）与抑郁症状（老年抑郁量表得分≥6；比值比：3.61，95%置信区间：1.30 - 10.04）和心力衰竭诊断（比值比：3.63，95%置信区间：1.30 - 10.11）相关。治疗后患者在巴氏指数、计时起立行走测试和Tinetti测试中的得分有所改善，但这些变化（Δ）与FES - I或SIQ的变化无显著相关性。我们的研究结果表明，FOF在因CGC住院的老年人中非常普遍，治疗后仅略有改善且持续存在。即使完成CGC后对跌倒持续高度担忧与抑郁症状和心力衰竭诊断相关。这些结果凸显了在CGC中进行更有针对性干预以更有效解决这一脆弱人群中FOF问题的潜力。
