What is the relation between fear of falling and physical activity in older adults?

Abstract

Objective: To describe the association between fear of falling (FOF) and total daily activity in older adults.

Design: Cross-sectional observational study.

Setting: Ambulatory clinical research training center.

Participants: Community-dwelling older adults aged ≥64 years (N=78), who were independent in ambulation with or without an assistive device.

Interventions: Not applicable.

Main outcome measures: FOF was defined by self-reported fear ratings using the Survey of Activities and Fear of Falling in the Elderly and self-reported fear status determined by response to the following question: Are you afraid of falling? Physical function was assessed using the Late Life Function and Disability Instrument. Physical activity was recorded using an accelerometer worn on the waist for 7 consecutive days, and mean daily counts of activity per minute were averaged over the 7-day period.

Results: Fear ratings were related to total daily activity (r=-.26, P=.02). The relation was not as strong as the relation of function and physical activity (r=.45, P<.001). When stratified by exercise status or functional status, fear was no longer related to total daily activity. Physical function explained 19% of the variance in physical activity, whereas the addition of fear status did not add to the explained variance in physical activity.

Conclusions: FOF is related to total daily physical activity; however, FOF was not independently associated with physical activity when accounting for physical function. Some FOF may be reported as a limitation in function.

Keywords: FOF; Fear; LLFDI; Late Life Function and Disability Instrument; Motor activity; PA; Rehabilitation; SAFFE; Survey of Activities and Fear of Falling in the Elderly; fear of falling; physical activity.

Figure 1

a. Relations of fear of falling, physical activity and function for total sample.. b. Relations of fear of falling, physical activity and function for groups defined by exercise status. SAFFE: Survey of Activities and Fear of Falling in the Elderly; LLFDI: Late Life Function and Disability Instrument. *p<.01 **Based on yes/no response to SAFFE activity scale question “Do you currently take a walk for exercise?”