The association between fear of falling and occurrence of falls: a one-year cohort study.

BACKGROUND: Both multiple fall experiences and fear of falling (FoF) would make people susceptible to another fall; however, the associations are unknown. This study investigates the association of FoF with fall occurrence among older adults according to their fall history. METHODS: In this study, we adopted a longitudinal observational design. We visited 20 community centers to recruit 1,025 older adults (aged 65 years or older). At baseline, FoF was assessed using a single-item questionnaire. The number of falls in the past year was obtained via a self-questionnaire and participants were classified into three fall history groups (0: non-faller, 1: single faller, 2 or more: multiple faller). After a year of following-up, the number of falls during the year was considered as the main outcome. Poisson regression models clarified the influence of FoF on fall occurrence during the one-year follow-up, according to the participants' fall history. RESULTS: The final sample comprised 530 individuals (follow-up rate: 530/801, 66.4%). Fall history, FoF, and interaction between multiple fallers and FoF were significant in the adjusted statistical model (rate ratio [95% confidence interval]: single faller = 2.81 [1.06, 6.30], multiple faller = 13.60 [8.00, 23.04], FoF = 3.70 [2.48, 5.67], multiple faller*FoF = 0.37 [0.20, 0.68]). CONCLUSIONS: We found that FoF was associated with the occurrence of falls in community-dwelling older adults. However, its association was lower in multiple fallers.

Does dual-tasking provide additional value in timed "up and go" test for predicting the occurrence of falls? A longitudinal observation study by age group (young-older or old-older adults).

BACKGROUND: Previous studies using relatively large samples and longitudinal observational designs reported dual-tasking had additional value in timed "up and go" test (TUG) for falls assessment among well-functioning older adults. AIM: To elucidate the additional value of dual-tasking in TUG for predicting the occurrence of falls among community-dwelling older adults by age group using a predictive model. METHODS: This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG without performing another task (single-TUG) and a TUG while counting aloud backward from 100 were conducted at baseline. We computed the dual-task cost (DTC) value, which is used to quantify trends in subjects' execution of motor tests under dual-task conditions. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. The final analysis included 649 individuals divided into a young-older adult group (aged 60-74 years) and an old-older adult group (aged ≥ 75 years). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. RESULTS: For old-older adults, there were significant associations between the occurrence of falls and single-TUG time (odds ratio [OR] 1.143, 95% confidence interval [CI] 1.018-1.285) and DTC value (OR 0.981, 95% CI 0.963-0.999). No significant associations were observed for young-older adults. CONCLUSIONS: Slower single-TUG time and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual tasking may provide an additional value in TUG for predicting falls among old-older adults.

Association of fall history with the Timed Up and Go test score and the dual task cost: A cross-sectional study among independent community-dwelling older adults.

AIM: To investigate the associations between fall history and the Timed Up and Go (TUG) test (single-TUG test), TUG test while counting aloud backwards from 100 (dual-TUG test) and the dual-task cost (DTC) among independent community-dwelling older adults. METHODS: This cross-sectional study included 537 older adults who lived independently in the community. Data on fall history in the previous year were obtained by self-administrated questionnaire. The single- and dual-TUG tests were carried out, and the DTC value was computed from these results. Associations between fall history and these TUG-related values were analyzed using multivariate logistic regression models. The participants were divided into fall risk groups using the cut-off values of those significantly associated with falling, and the odds ratios (OR) were computed. RESULTS: Slower single-TUG test scores and lower DTC values were significantly associated with fall history after adjusting for potential confounders (single-TUG test score: OR 1.133, 95% CI 1.029-1.249; DTC value: OR 0.984, 95% CI 0.968-0.998). Older adults with slower single-TUG test scores and lower DTC values reported a fall history more often than those in other categories (OR compared with the lower-risk single-TUG and lower-risk DTC groups: 3.474, 95% CI 1.881-6.570). CONCLUSIONS: Slower single-TUG test scores and lower DTC values are associated with fall history among independent community-dwelling older adults. To some extent, dual task performance might provide added value for fall assessment, compared with administering the TUG test alone. Geriatr Gerontol Int 2018; 18: 1189-1193.