Fear of falling limiting activity in young-old women is associated with reduced functional mobility rather than psychological factors

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Abstract
Background: many older people experience fear of falling. This is sometimes associated with activity limitation, with potential adverse health implications. The explanatory contributions of physical and psychosocial factors to this syndrome are unclear. Objectives: to examine the associations between fear of falling limiting activity (FoF-LA) among young-old women with (i) functional capacity and (ii) psychological factors. Subjects and methods: FoF-LA, functional difficulty and dependency, psychological factors, previous falls, visual and hearing handicap, memory, pain, and habitual physical activity were assessed using standard questionnaires in 713 community-dwelling London women, mean age 64.2 years. Results: 70 women (10.1%) reported FoF-LA, of whom 21 had fallen in the previous year. Women reporting FoF-LA had higher prevalence of adverse functional and clinical characteristics. Multiple logistic regression analyses showed that both mild (‘changes in the way walk half a mile’) and moderate (‘difficulty standing from armless chair’) reduction in functional capacity were independently associated with FoF-LA (odds ratios 4.02 (95% CI 1.5–10.7) and 5.07 (CI 2.0–13.0) respectively) after adjustment for age, falls and clinical factors. Psychological factors and perceived fair/poor health were bivariately but not independently associated with FoF-LA; after adjustment for them, mild and moderate reductions in functional capacity remained strongly associated with FoF-LA (OR 4.02 (CI 1.5–10.7) and 3.83 (CI 1.4–10.5) respectively), along with visual handicap and increased health service use. Conclusions: among young-old women, FoF-LA is related to early reduction of mobility function rather than psychological factors. It may identify individuals at risk of subsequent functional decline.

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