Effect of Fall-Related Concerns on Physical, Mental, and Social Function in Community-Dwelling Older Adults: A Prospective Cohort Study

ObjectivesTo determine the effect of fall-related concerns on physical, mental, and social function.

DesignCommunity-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial).

SettingTwo municipalities in the south of the Netherlands.

ParticipantsCommunity-dwelling older adults (N= 260).

MeasurementsTwo groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline.

ResultsAt baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14months.

ConclusionOlder persons with higher levels of fall-related concerns reported up to 14months poorer ADL and social participation for up to 14months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls.