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Mon S. Bryant, Diana H. Rintala, Jyh-Gong Hou, and Elizabeth J. Protas

Aim:

To investigate the relationships between falls, fear of falling, and activity limitations in individuals with Parkinson’s disease (PD).

Design/methods:

Cross-sectional study of individuals with mild to moderate PD (N = 83). Associations among demographic data, fall frequency, disease severity, motor impairment, ability to perform activities of daily living (ADL), Activities Balance Confidence Scale, Iowa Fatigue Scale, Comorbidity Index, and Physical Activity Scale for Elders were studied.

Results:

Frequent fallers had more ADL limitations than nonfallers (p < .001) and rare fallers (p = .004). Frequent fallers reported a lower percentage of ability to perform ADL than nonfallers (p = .003). Frequent fallers and rare fallers were less physically active than nonfallers (p = .015 and p = .040, respectively). Frequent fallers and rare fallers reported a higher level of fear of falling than nonfallers (p = .031 and p = .009, respectively).

Conclusions:

Falls and fear of falling were associated with more ADL limitations and less physical activity after adjusting for physical impairments.

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Lise Kronborg, Thomas Bandholm, Henrik Palm, Henrik Kehlet, and Morten Tange Kristensen

Early mobilization following hip fracture surgery reduces medical complications and mortality, but may increase the risk of falling. The aim was to objectively measure the physical activity (time spent upright) the first week after hip fracture surgery and relate it to functional performance and fear of falling at discharge. The 24-hr upright time was measured for a median of six days using a thigh-worn accelerometer in 37 patients (mean 80 years ± 8.4) and increased from median 13 (IQR 6–31) min to 46 (11–107) min at day 7. More upright time at discharge was associated with less fear of falling (r = –.48, p = .01, n = 27), which also was associated with fast gait speed (r = –.50, p = .02, n = 23) and a faster Timed Up and Go test time (r = .54, p < .01, n = 22), indicating a need for further studies on motivation and limitations for more physical activity following hip fracture surgery.

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Matteo Ponzano, Jenna C. Gibbs, Jonathan D. Adachi, Maureen C. Ashe, Angela M. Cheung, Keith D. Hill, David Kendler, Aliya A. Khan, Caitlin McArthur, Alexandra Papaioannou, Lehana Thabane, John D. Wark, and Lora M. Giangregorio

, Papaioannou, et al., 2014 ). However, fear of falling is a common issue among individuals with osteoporosis and is strongly associated with decreased health-related quality of life ( Guillemin et al., 2013 ). Fear of falling is a persistent concern of falling that makes people avoid certain activities, even

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Jaquelini Betta Canever, Ana Lúcia Danielewicz, Amanda Aparecida Oliveira Leopoldino, Maruí Weber Corseuil, and Núbia Carelli Pereira de Avelar

Fear of falling can be defined as an exacerbated concern about falling during daily activities ( Jung, 2008 ) and its current prevalence in community-dwelling older adults differs in different countries, with variations between 41.7% in Spain ( Lavedán et al., 2018 ), 48.40% in Brazil ( Canever et

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Ana Carla Lima Nunes, Fabianna Resende Jesus-Moraleida, Pedro Olavo de Paula Lima, and Merrill R. Landers

Fear of falling (FoF) is common among community-dwelling older adults regardless of having yet experienced a fall ( Zijlstra et al., 2007 ). FoF has been associated with higher age, female gender, poor perceived general health, multiple falls, and decreases in physical activity or physical health

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Kazuhiro Harada, Hyuntae Park, Sangyoon Lee, Hiroyuki Shimada, Daisuke Yoshida, Yuya Anan, and Takao Suzuki

This study examined associations between perceived neighborhood environment and physical activity among frail older adults and whether these associations are moderated by fear of falling. Participants were 238 frail older adults. Daily step counts and duration of moderate-to-vigorous physical activity were measured using an accelerometer. Participants completed the abbreviated Neighborhood Environment Walkability Scale; fear of falling and demographic and health-related factors were measured by a questionnaire. The interaction between crime safety and fear of falling was significantly associated with step count (p = .009) and moderate-to-vigorous physical activity (p = .018) in multiple regression analysis. Stratified according to fear of falling, crime safety was significantly associated with steps (p = .007) and moderate-to-vigorous physical activity (p = .030) in the low fear of falling group. The results suggest that crime safety is associated with physical activity among frail older adults, and this association is moderated by fear of falling.

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Edward McAuley, Shannon L. Mihalko, and Karl Rosengren

This study examined relationships among physical activity patterns, self-efficacy, balance, and fear of falling in older adults. Fifty-eight older adults (52-85 years) completed measures of physical activity, self-efficacy, and fear of falling. Subjects then performed the items found in the Berg Balance Scale (Berg, Wood-Dauphinee, Williams, & Maki, 1992). More physically active adults were less fearful of falling, had better balance, and had stronger perceptions of efficacy. Those with better balance were less fearful of falling, and females were more fearful than males. Balance and self-efficacy had significant independent effects on fear, whereas the contribution of history of physical activity was nonsignificant. The findings suggest that behavioral, social cognitive, and biological factors may be important correlates of fear of falling. Further support is provided for the utility of self-efficacy measures in the prediction of fear of falling, although reliance on any one measure to assess this construct may underestimate the role of self-efficacy.

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Ellen Freiberger

fall-related psychological concerns (FrPC) including fear of falling, as well as the other side of the coin, self-efficacy. Environmental risk factors are, for example, loose carpets, low lightening, or missing handrails ( Todd & Skelton, 2004 ). Preventive interventions with the most positive

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Dennis W. Klima, Roberta A. Newton, Emily A. Keshner, and Adam Davey

Studies examining fear of falling among older adult men remain limited. The objectives of this study were to compare balance confidence in 2 age cohorts of older clergy and identify predictive determinants of balance confidence in a liturgical research initiative. Participants included 131 community-dwelling Roman Catholic priests age 60–97 yr living in religious communities in 10 mid-Atlantic states. Subjects completed the Activities-specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), timed up-and-go (TUG) test, and 15-item Geriatric Depression Scale (GDS). Younger priests (60–74 yr) demonstrated a significantly higher ABC score than the older cohort (75 and above yr) of priests (89.1 ± 12.6 vs.78.4 ± 13.9, p = .001). Confidence was significantly correlated with BBS (rho = .69, p < .01), TUG (r = –.58, p < .01), and GDS (r = –.39, p < .01) scores. A stepwise-regression model demonstrated that balance ability, mood, assistive-device use, and physical activity predicted 52% of the variance in balance confidence.

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Saija Karinkanta, Ritva Nupponen, Ari Heinonen, Matti Pasanen, Harri Sievänen, Kirsti Uusi-Rasi, Mikael Fogelholm, and Pekka Kannus

This randomized, controlled trial evaluated the effects of exercise on health-related quality of life (HRQoL) and fear of falling (FoF) among 149 home-dwelling older women. The 12-mo exercise program was intended to reduce the risk of falls and fractures. HRQoL was assessed by the RAND-36 Survey, and FoF, with a visual analog scale, at baseline, 12 mo, and 24 mo. On all RAND-36 scales, the scores indicated better health and well-being. The exercise had hardly any effect on HRQoL; only the general health score improved slightly compared with controls at 12 mo (p = .019), but this gain was lost at 24 mo. FoF decreased in both groups during the intervention with no between-groups difference at 12 or 24 mo. In conclusion, despite beneficial physiological changes, the exercise intervention showed rather limited effects on HRQoL and FoF among relatively high-functioning older women. This modest result may be partly because of insufficient responsiveness of the assessment instruments used.