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. 2017 Dec 21;17(1):291.
doi: 10.1186/s12877-017-0682-2.

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study

Yong-Hao Pua  1 , Peck-Hoon Ong  2 , Ross Allan Clark  3 , David B Matcher  4 , Edwin Choon-Wyn Lim  2
Affiliations

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study

Yong-Hao Pua et al. BMC Geriatr. .

Abstract

Background: Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline.

Methods: Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured.

Results: In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001).

Conclusion: Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted.

Trial registration: ClinicalTrials.gov identifier: NCT01713543 .

Keywords: Balance; Falls; Falls efficacy.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the centralised institutional review board (2012/147/A) and registered on 24 October 2012 with the U.S. Clinical Trial Registry (NCT01713543). All participants provided written informed consent.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Interaction plot of Modified Falls Efficacy Scale (MFES) and centre-of-pressure (CoP) velocity-AP and probability of falling at least once in the follow-up period. Low and high falls efficacy represent the 25th and 75th percentile values of the MFES, respectively. Predicted fall risk was computed from a proportional odds model which included the interaction between MFES and CoP velocity-AP, adjusted for age, sex, number of comorbidities, fall history, baseline SPPB, and treatment group assignment (P = 0.014 for interaction). Shaded regions represent 95%CIs for the natural spline-smoothed estimates
Fig. 2
Fig. 2
Lower scores on the Modified Falls Efficacy Scale (MFES) were independently associated with slower (worse) gait speed at 6 months post-baseline assessment, after adjustment for age, sex, number of comorbidities, fall history, baseline gait speed, treatment group assignment, and postural balance. Shaded regions represent 95% CI for the point estimates. Rug plots show the observed baseline MFES values
See this image and copyright information in PMC

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