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

Finbarr C. Martin, Deborah Hart, Tim Spector, David V. Doyle, Danielle Harari
2005 Age and Ageing  
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
more » ... cy, psychological factors, previous falls, visual and hearing handicap, memory, pain, and habitual physical activity were assessed using standard questionnaires in 713 communitydwelling 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. Abstract Background: we developed the Caregivers for Alzheimer's disease Problems Scale (CAPS) comprising common risk factors for anxiety and depression for family carers of people with dementia. Objective: to calculate the sensitivity and specificity of the CAPS in order to measure its usefulness in identifying dementia caregivers at risk of anxiety and depression and therefore whether it identifies clinically relevant areas for intervention or highlights the need for support if the problem could not be changed. Method: 153 family caregivers were interviewed as part of a larger epidemiologically representative study of people with Alzheimer's disease and their caregivers. Caregiver anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Results: the CAPS had high sensitivity and specificity in detecting caregivers with screen positive anxiety and depression. Five areas were indicated: neuropsychiatric symptoms and depression in the care-recipient, co-residence and relationships with the care-recipient, and physical health of the caregiver. Conclusions: awareness of these problems can help clinicians identify those carers most likely to be anxious or depressed and indicate appropriate intervention and support. We recommend that this instrument be used as part of routine assessments of people with dementia and their families.
doi:10.1093/ageing/afi074 pmid:15863412 fatcat:4chnncclynarpf5r265edcpara