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Concern About Falling in a Mexican Clinical Cohort of Adults Aged ≥65 Years: Postfall Syndrome Construct
Angela Patricia Gómez-Rodríguez1, Melissa Hughes-García2, Brenda Anahí Galera-Gámez1
1Geriatrics Department, Hospital Clínica Nova de Monterrey, San Nicolás, Nuevo León, México.
Objectives:
To identify clinical and geriatric factors associated with concern about falling (CAF) among Mexican older adults with a history of falls.
Design:
Analytical cross-sectional observational study.
Setting And Participants:
Adults aged ≥65 years attending a geriatric outpatient clinic at a semiprivate tertiary care center in Northeastern Mexico who reported at least 1 fall in the previous 2 years and underwent a comprehensive geriatric assessment.
Methods:
CAF was assessed using the culturally adapted and validated Spanish-language Mexican version of the Falls Efficacy Scale-International and categorized as low concern (LC, 16-19), moderate concern (MC, 20-27), or severe concern (SC, 28-64). Data were collected from medical records and caregiver reports. Group comparisons were performed using analysis of variance, Kruskal-Wallis, and χ2 tests as appropriate. A multinomial logistic regression was used to identify factors associated with moderate and severe CAF, using LC as the reference.
Results:
Among 391 participants (mean [SD] age, 78.6 [SD, 7.7] years; 60.4% women), 112 had LC, 159 MC, and 120 SC. In multinomial models, MC was independently associated with a higher number of falls (odds ratio [OR], 2.07), hospitalizations (OR, 4.01), type 2 diabetes mellitus (OR, 2.44), gait disorders (OR, 3.32), frailty (OR, 2.25), and female sex (OR, 2.00). SC was associated with greater fall frequency (OR, 2.93), hospitalizations (OR, 6.37), emergency room visits (OR, 1.84), higher medication count (OR, 1.22), and female sex (OR, 2.80).
Conclusions And Implications:
CAF was associated with a multidimensional clinical phenotype linked to frailty, functional decline, polypharmacy, and health care utilization. Stratifying CAF severity may help identify distinct vulnerability profiles among older adults with falls. Incorporating CAF assessment into comprehensive geriatric evaluation may improve risk stratification and guide individualized multidomain interventions aimed at preserving mobility and functional independence.
