Risk factors for restriction in activity associated with fear of falling among seniors within the community

Despite the significance of falling, fear of falling may represent a greater pervasive concern to the health of seniors. Activity restriction, resulting from fear of falling, which may or may not develop after a fall, may lead to balance deterioration, functional decline, anxiety or reductions in social/leisure/physical activity opportunities, and, consequently, compromised quality of life and health.

The purpose of this research was to determine the risk factors for activity restriction resulting from fear of falling among community-based seniors using an early version of the interRAI Community Health Assessment (interRAI CHA). All participants (n = 560) were enrolled in 1 of 5 different fall intervention programs in Ontario funded through the Falls Prevention Initiative sponsored by Health Canada and Veterans Affairs Canada. All participants (or a predetermined number of seniors if the subject pool was extensive) were assessed both before and after intervention. Subjects were assessed using the interRAI CHA.

Thirty-five percent of seniors reported restricting their activity as a result of fear of falling. Risk factors predictive of activity restriction included previous history of falling, compromised instrumental activities of daily living, compromised cognitive performance, presence of pain, female sex, and impaired gait.

Fear of falling is a prevalent issue among seniors, which has the potential to alter their quality of life and morbidity, and as such, including fear of falling in public health programs, health policies, and screening efforts seems imperative. The present findings add to the present research on risk factors for activity restriction because of fear of falling. These findings do not advocate for restriction of activity to prevent falls because restriction is not a good solution to fall prevention. Using a standardized and comprehensive tool such as the interRAI CHA would assist researchers in making comparisons between different research groups as well as assessing fear of falling from a multidisciplinary perspective.