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Concern About Falling Is a Predictor of Fall Risk in Older Patients With Cardiovascular Disease - A 1-Year
Masakazu Saitoh1,2, Ryuichi Sawa1,2, Kohei Shiota2
1Department of Physical Therapy, Faculty of Health Science, Juntendo University Tokyo Japan.
Insights
Fear of falling, measured by the Falls Efficacy Scale International (FES-I), significantly predicts future falls in older adults with cardiovascular disease (CVD). A FES-I score of 28 or higher indicates increased fall risk.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Public Health
Background:
- Older adults with cardiovascular disease (CVD) are at increased risk of falls.
- Identifying fall risk indicators is crucial for preventing falls in this population.
- Multidimensional assessments can provide comprehensive insights into fall risk.
Purpose of the Study:
- To identify fall risk indicators in older patients with cardiovascular disease (CVD).
- To assess the association between multidimensional factors and future falls.
- To determine the predictive value of the Falls Efficacy Scale International (FES-I) for falls.
Main Methods:
- Prospective cohort study of 129 patients aged ≥65 years with CVD.
- 1-year follow-up to classify participants into fall and non-fall groups.
- Assessment of physical frailty, blood pressure, polypharmacy, and FES-I scores.
Main Results:
- Overall 1-year fall incidence was 17.0%.
- The fall group was older, with lower physical function and blood pressure, and higher FES-I scores.
- A FES-I score ≥28 was a significant predictor of falls (adjusted OR 2.964, P=0.042).
Conclusions:
- Fall incidence in older adults with CVD is comparable to community-dwelling populations.
- Higher concern about falling (FES-I score) is significantly associated with future falls.
- FES-I is a valuable tool for identifying fall risk in older adults with CVD.
Background:
This study aimed to identify fall risk indicators associated with future falls among older patients with cardiovascular disease (CVD), based on a multidimensional assessment.
Methods And Results:
In this prospective cohort study, 129 patients aged ≥65 years with CVD were enrolled between 2021 and 2023. Participants were classified into fall and non-fall groups based on fall incidence during a 1-year follow up. We assessed physical frailty, systolic blood pressure, polypharmacy, and the Falls Efficacy Scale International (FES-I) to evaluate concern about falling. The overall 1-year fall incidence was 17.0% (22 falls), equating to 0.28 falls per person-year. Compared with the non-fall group, the fall group was older, had lower physical function and blood pressure, and higher FES-I scores. Multivariate logistic regression, adjusted with propensity scores, revealed that a FES-I score ≥28 was a significant predictor of falls (odds ratio [OR] 8.906, 95% confidence interval [CI] 2.556-13.031, P=0.001; adjusted OR 2.964, 95% CI 1.038-8.460, P=0.042). Receiver operating characteristic analysis identified a FES-I cut-off of 28, with an area under the curve of 0.684 (95% CI 0.527-0.840, P=0.017).
Conclusions:
The 1-year fall incidence among older patients with CVD was comparable with rates in community-dwelling older adults. Higher concern about falling, as measured using FES-I, was significantly associated with future falls.
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