The role of postural instability/gait difficulty and fear of falling in predicting falls in non-demented older adults |
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| Institution: | 1. SDSU/UCSD Joint Doctoral Program in Clinical PsychologySan Diego, CA;2. the VA San Diego Healthcare System, and Department of Psychiatry University of California, San Diego, CA;3. Department of Psychology, University of Southern California, Los Angeles, CA;4. Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO;1. Falls, Balance and Injury Research Center, Neuroscience Research Australia, Australia;2. Cognitive Decline Partnership Centre, Sydney Medical School, University of Sydney, Australia;3. Department of Medicine, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia;4. School of Public Health and Community Medicine, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia |
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| Abstract: | IntroductionPostural instability/gait difficulty (PIGD) and fear of falling (FoF) frequently co-exist, but their individual predictive values for falls have not been compared in aging. This study aims to determine both independent and combined effect of PIGD and FoF to falls in older adults without dementia.MethodsPIGD and other extrapyramidal signs were systematically assessed in 449 community-dwelling participants without Parkinson’s disease (76.48 ± 6.61 ys; 56.8% female) enrolled in this longitudinal cohort study. Presence of FoF was measured by a single-item question (Do you have a FoF?) and self-confidence by the Activities-specific Balance Confidence scale (ABC scale).ResultsOne hundred sixty-nine participants (38%) had an incident fall over a mean follow-up of 20.1 ± 12.2 months. PIGD was present in 32% and FoF in 23% of the participants. Both PIGD (adjusted hazard ratio (aHR): 2.28; p = 0.016) and self-confidence (aHR: 0.99; p = 0.040) predicted falls when entered simultaneously in the Cox model. However, presence of FoF (aHR: 1.99; p = 0.021) and self-confidence (aHR: 0.98; p = 0.006) predicted falls only in individuals with PIGD.ConclusionsPIGD and FoF were associated with future falls in older adults without dementia but FoF was a fall’s predictor only in individuals with PIGD. |
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| Keywords: | Fall Fear of falling Postural instability/gait difficulty Extrapyramidal signs Aging |
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