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Publication Date: 2012-07-01
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Curcio CL, Gómez Montes F. Fear of falling in the elderly: controversy around a concept and its assessment. Hacia Promoc. Salud [Internet]. 2012 Jul. 1 [cited 2024 Nov. 24];17(2):199-217. Available from: https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/2042
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Abstract
Introduction: The definition of fear of falling and the instruments to assess it are key to determine the scale of the problem and establish appropriate intervention strategies.. The aim of this paper is to provide a critical analysis of definitions and constructs of fear of falling and assessment tools. Methods: Around 1,200 publications issued between 1980 and 2011 were found in diverse data bases and libraries. The exclusion criteria were: language different from English, French, Portuguese and Spanish; including population younger than 60 years old; not having as a central aim fear of falling and being duplicated. Based on these criteria, 337 documents were retained for this literature review. Results: Different concepts and terms have been used to define and assess fear of falling. The most common are decrease in self-efficacy, trust in equilibrium, worry, concern or anxiety about falls, fear of falling, control perceived about falling and fear of falling syndrome. There are more than twelve fear of falling assessment instruments, from the simple question to elaborated instruments to assess the different constructs. Discussion / Conclusions: Fear of falling refers to the possibility of a future event; trust in equilibrium and selfefficacy refer to perceptions related with the real capacities of the person, this is to say they are three different constructs.. Further research is needed regarding the conceptualization of fear of falling. The conceptual clarity and precision can be useful in developing strategies tailored to the individual and group needs.
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References
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Yardley L, Smith H. Prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. Gerontologist. 2002; 42(1): 17-23.
Lawrence RH, Tennstedt SL, Kasten LE, Shih J, Howland J, Jette AM. Intensity and correlates of fear of falling and hurting oneself in the next year. J Aging Health. 1998; 10: 267-86.
Scheffer AC, Schuurmans MJ, Van Dijk N, Van der Hooft T, De Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing. 2008; 37(1): 19-24.
Jorstad E, Hauer K, Becker C, Lamb SE. Measuring of psychological outcomes of falling: a systematic review. Journal of the American geriatrics society. 2005; 53: 501-510.
Franzoni S, Rozzini R, Boffelli S, Frisoni GB, Trabucchi M. Fear of falling in nursing home patients. Gerontology. 1994; 40: 38-44.
Gagnon N, Flint A, Naglie G, Devins G. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry. 2005; 13(1): 7-14.
Gillespie SM, Friedman SM. Fear of Falling in New Long-Term Care Enrollees. American Medical Directors Association. 2007; 8: 307-313.
Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health. 1994; 84(4): 565-570.
Howland J, Lachman ME, Peterson EW, Cote J, Kasten L, Jette A. Covariates of fear of falling and associated activity curtailment. Gerontologist. 1998; 38(5): 549-555.
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Suzuki M, Ohyama N, Yamada K, Kanamori M. The relationships between fear of falling, activities of daily living and quality of life among elderly individuals. Nursing and health sciences. 2002; 4: 155-161.
Ness KK, Gurney JG, Wall MM, Olsen RA, Boregerhoff LA. Screening for risk of falling in community-dwelling elderly people may increase fear of falling. Journal of Geriatric Physical therapy. 2003; 27(3): 100-104.
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Curcio CL, Gómez F, Reyes-Ortiz CA. Activity Restriction Related to Fear of Falling Among Older People in the Colombian Andes Mountains: Are Functional or Psychosocial Risk Factors More Important? J Aging Health. 2009; 21: 460-479.
Austin N, Devine A, Dick I, Prince R, Bruce D. Fear of Falling in Older Women: A Longitudinal Study of Incidence, Persistence, and Predictors. Journal of the American Geriatrics Society. 2007; 55: 1598-1603.
Kellogg International Working Group on the Prevention of falls by the Elderly. The prevention of falls in later life. Danish Medical Bulletin. 1987; 34(4): 215-219.
Pérez-Jara J, Enguix A, Fernández-Quintas JM, Gómez-Salvador B, Baz R, Olmos P et al. Fear of falling among elderly patients with dizziness and syncope in a tilt setting. Canadian Journal on Aging / Revue canadienne du vieillissement. 2009; 28(2): 157-163.
Rosso-Henao V, Reyes-Ortiz CA, Gómez JF, Curcio CL, Ottenbacher KJ, Markides KS. The temporal relationship between falls and fear of falling among older Mexican Americans. Journal of the American Geriatrics Society. 2007; 55(4 Supp 1): S195.
Cummings RG, Salked G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol. 2000; 55A(5): M299-M305.
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Baloh RW, Jacobson KM, Socotch TM, Spain S, Bell T. Posturography and concerns about falling in older people. Facts & research in Gerontology. 1996; 51-62.
Kempen GI, Van Haastregt JC, McKee KJ, Delbaere K, Zijlstra GA. Socio-demographic, healthrelated and psychosocial correlates of fear of falling and avoidance of activity in community-living older persons who avoid activity due to fear of falling. BMC Public Health. 2009; 9: 170-177.
Cameron ID, Stafford B, Cumming RG. Hip protectors improve falls self-efficacy. Age & Ageing. 2000; 29: 57-62.
Boyd R, Stevens JA. Falls and fear of falling: burden, beliefs and behaviours. Age and Ageing. 2009; 38: 423-428.
Delbaere K, Kombez G, Vanderstraeten G, Willems T, Cambier D. Fear-related avoidance of activities, falls and physical frailty. A prospective community-based cohort study. Age & Aging. 2004; 33: 368-373.
Velozo CA, Peterson EW. Developing meaningful fear of falling measures for community dwelling elderly. Am J Phys Med Rehabil. 2001; 80: 662-673.
Huang TT. Geriatric fear of falling measure: development and psychometric testing. International Journal of Nursing Studies. 2006; 43(3): 357-365.
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Blanchard RA, Myers AM, Pearce NJ. Reliability, construct validity, and clinical feasibility of the activities-specific fall caution scale for residential living seniors. Archives of Physical and Medical Rehabilitation. 2007; 88: 732-739.
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Murphy J, Isaacs B. The post-fall syndrome. A study of 36 patients. Gerontology. 1982; 28: 265-270.
Tinetti M, Richman D, Powel L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990; 45(6): P239-P243.
Chandler J, Duncan P, Sander L, Studensky S. The fear of falling syndrome: relationships to falls, physical performance, and activities of daily living in frail older persons. Topics in Geriatric Rehabilitation. 1996; 11(3): 55-63.
Buchner DM, Hornbrook MC, Kutner NG, Tinetti ME, Ory MG, Mulrow CD, Schechtman KB, Gerety MB, Fiatarone MA, Wolf SL et al. FICSIT Group. Development of the common database for the FICSIT trial. Journal of the American Geriatrics Society. 1993; 41: 297-308.
Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. Journal of Gerontology: Medical Sciences. 1995; 50A: 28-34.
Yardley L, Smith H. Prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. Gerontologist. 2002; 42(1): 17-23.
Lawrence RH, Tennstedt SL, Kasten LE, Shih J, Howland J, Jette AM. Intensity and correlates of fear of falling and hurting oneself in the next year. J Aging Health. 1998; 10: 267-86.
Scheffer AC, Schuurmans MJ, Van Dijk N, Van der Hooft T, De Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing. 2008; 37(1): 19-24.
Jorstad E, Hauer K, Becker C, Lamb SE. Measuring of psychological outcomes of falling: a systematic review. Journal of the American geriatrics society. 2005; 53: 501-510.
Franzoni S, Rozzini R, Boffelli S, Frisoni GB, Trabucchi M. Fear of falling in nursing home patients. Gerontology. 1994; 40: 38-44.
Gagnon N, Flint A, Naglie G, Devins G. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry. 2005; 13(1): 7-14.
Gillespie SM, Friedman SM. Fear of Falling in New Long-Term Care Enrollees. American Medical Directors Association. 2007; 8: 307-313.
Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health. 1994; 84(4): 565-570.
Howland J, Lachman ME, Peterson EW, Cote J, Kasten L, Jette A. Covariates of fear of falling and associated activity curtailment. Gerontologist. 1998; 38(5): 549-555.
Howland J, Walker E, Levin WC, Fried L, Pordon D, Bak S. Fear of falling among the communitydwelling elderly. Journal of aging and health. 1993; 5(2): 229-43.
Fessel KD, Nevitt MC. Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis. Arth Care Res. 1997; 10: 222-228.
Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age & aging. 1997; 26: 189-93.
Andresen EM, Wolinsky FD, Miller JP, Wilson MM, Malsmstron TK, Miller DK. Cross-sectional and longitudinal risk factors for falls, fear of falling, and falls efficacy in a cohort of middle-aged African Americans. The gerontologist. 2006; 46(2): 249-257.
Friedman S, Muñoz B, West S, Rubin G, Fried l. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. Journal of the American Geriatrics Society. 2002; 50(13): 29-35.
Suzuki M, Ohyama N, Yamada K, Kanamori M. The relationships between fear of falling, activities of daily living and quality of life among elderly individuals. Nursing and health sciences. 2002; 4: 155-161.
Ness KK, Gurney JG, Wall MM, Olsen RA, Boregerhoff LA. Screening for risk of falling in community-dwelling elderly people may increase fear of falling. Journal of Geriatric Physical therapy. 2003; 27(3): 100-104.
Murphy S, Dubin JA, Gill TM. The development of fear of falling among community-living older women: predisposing factors and subsequent fall events. J gerontol. 2003; 58A(19): 943-947.
Curcio CL, Gómez JF. Factores predictores de temor a caer. Rev Asoc Colomb Gerontol Geriatr. 2006; 20(4): 959-970.
Lach H. Incidence and risk factors for developing fear of falling in older adults. Public Health Nursing. 2005; 22(1): 45-52.
Yeung FKC, Chou KL, Wong EC. Characteristics associated with fear of falling in Hong Kong Chinese elderly residing in care and attention homes. Clinical Gerontologist. 2006; 29(3): 83-98.
Gómez F, Curcio CL. The development of a fear of falling interdisciplinary intervention program. Clin Interv Aging. 2007; 2(4): 661-667.
Curcio CL, Gómez F, Reyes-Ortiz CA. Activity Restriction Related to Fear of Falling Among Older People in the Colombian Andes Mountains: Are Functional or Psychosocial Risk Factors More Important? J Aging Health. 2009; 21: 460-479.
Austin N, Devine A, Dick I, Prince R, Bruce D. Fear of Falling in Older Women: A Longitudinal Study of Incidence, Persistence, and Predictors. Journal of the American Geriatrics Society. 2007; 55: 1598-1603.
Kellogg International Working Group on the Prevention of falls by the Elderly. The prevention of falls in later life. Danish Medical Bulletin. 1987; 34(4): 215-219.
Pérez-Jara J, Enguix A, Fernández-Quintas JM, Gómez-Salvador B, Baz R, Olmos P et al. Fear of falling among elderly patients with dizziness and syncope in a tilt setting. Canadian Journal on Aging / Revue canadienne du vieillissement. 2009; 28(2): 157-163.
Rosso-Henao V, Reyes-Ortiz CA, Gómez JF, Curcio CL, Ottenbacher KJ, Markides KS. The temporal relationship between falls and fear of falling among older Mexican Americans. Journal of the American Geriatrics Society. 2007; 55(4 Supp 1): S195.
Cummings RG, Salked G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol. 2000; 55A(5): M299-M305.
Yardley L. Fear of imbalance and falling. Reviews in clinical gerontology. 1998; 8: 23-29.
Lachman ME, Howland J, Tennsted S, Jette A, Assman S, Peterson E. Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). J Gerontol. 1998; 53B: P43-P50.
Brower B, Musselman K, Culham E. Physical function and health status among senior with and without fear of falling. Gerontology. 2004. 50: 135-41.
Baloh RW, Jacobson KM, Socotch TM, Spain S, Bell T. Posturography and concerns about falling in older people. Facts & research in Gerontology. 1996; 51-62.
Kempen GI, Van Haastregt JC, McKee KJ, Delbaere K, Zijlstra GA. Socio-demographic, healthrelated and psychosocial correlates of fear of falling and avoidance of activity in community-living older persons who avoid activity due to fear of falling. BMC Public Health. 2009; 9: 170-177.
Cameron ID, Stafford B, Cumming RG. Hip protectors improve falls self-efficacy. Age & Ageing. 2000; 29: 57-62.
Boyd R, Stevens JA. Falls and fear of falling: burden, beliefs and behaviours. Age and Ageing. 2009; 38: 423-428.
Delbaere K, Kombez G, Vanderstraeten G, Willems T, Cambier D. Fear-related avoidance of activities, falls and physical frailty. A prospective community-based cohort study. Age & Aging. 2004; 33: 368-373.
Velozo CA, Peterson EW. Developing meaningful fear of falling measures for community dwelling elderly. Am J Phys Med Rehabil. 2001; 80: 662-673.
Huang TT. Geriatric fear of falling measure: development and psychometric testing. International Journal of Nursing Studies. 2006; 43(3): 357-365.
Lusardi MM, Smith EV Jr. Development of a scale to asses concern about falling and applications to treatment programs. J Outcome Meas. 1997; 1: 34-55.
Tinetti ME, Mendes de León CF, Doucette JT, Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol. 1994; 49: M140-M147.
Hill KD, Schwarz JA, Kalogeropoulos AJ, Gibson SJ. Fear of falling revisited. Arch Phys Med Rehabil. 1996; 77: 1025-9.
Hellström K, Lindmark B, Fugl-Meyer A. The Falls-Efficacy Scale, Swedish version: does it reflect clinically meaningful changes after stroke? Disability and Rehabilitation. 2002; 24(9): 471-481.
Parry SW, Steen N, Galloway RS. Falls and confidence related quality of life outcome measures in an older British cohort. Postgrad Med. 2001; 77: 103-108.
Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Tood C. Development and initial validation of the falls efficacy scale-international (FES-I). Age & aging. 2005; 34: 614-619.
Kempen GI, Todd CJ, Van Haastregt JC, Zijlstra GA, Beyer N, Freiberger E, Hauer KA, PiotZiegler C, Yardley L. Cross-cultural validation of the Falls Efficacy Scale International (FES-I) in older people: Results from Germany, the Netherlands and the UK were satisfactory. Disability & Rehabilitation. 2007; 29(2): 155-162.
Simpson JM, Worsfold C, Hawke J. Balance confidence in elderly people: The CONFbal scale. Age & Ageing. 1998; 27 Suppl 2: 57-61.
Simpson JM. Questionnaires: Concern about falling, Balance confidence, concern regarding the consequences of falling. Prevention of Falls Network Europe Work Package 4 Consensus Meeting. Southampton: University of Southampton; 2003.
Shumway-Cook A, Baldwin M, Polissar NL, Bruber W. 1997. Predicting the probability for falls in community-dwelling older adults. Physical Therapy. 1997; 77(8): 812-819.
Simpson JM. Having fallen does not fully explain fear of falling. British Psychological Society Annual Conference. London: BPS Publications; 2000.
Warnke A, Meyer G, Bott U, Muhlhauser I. Validation of quality of life questionnaire measuring the subjective fear of falling in nursing home residents. Z Gerontol Geriatr. 2004; 37: 459-466.
Blanchard RA, Myers AM, Pearce NJ. Reliability, construct validity, and clinical feasibility of the activities-specific fall caution scale for residential living seniors. Archives of Physical and Medical Rehabilitation. 2007; 88: 732-739.
Resnick B. Functional performance of older adults in a long-term care setting. Clin Nurs Res. 1998; 7: 230-249.
Huang T. Managing fear of falling: Taiwanese elders’ perspective. International journal of nursing studies. 2005; 42: 743-50.
Legters C, Wtihney S, Porter R, Buczek F. The relationships between activities specific Balance confidence scale and the dynamic gait index in peripheral vestibular dysfunction. Physiotherapy research International. 2005; 10(1): 10-22.
Hatch J, Gill-body KM, Portney LG. Determinants of balance confidence in community-dwelling elderly people. Phys Ther. 2003; 83: 1072-1079.
Legters K. Fear of falling. Phys Ther. 2002; 82(3): 264-272.
Li F, McAuley E, Fisher KJ, Harmer P, Chaumeton N, Wilson, N. Self-efficacy as a mediator between fear of falling and functional ability in the elderly. J Aging Health. 2002; 14(4): 452-466.
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