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. 2023 Sep;35(9):1937-1944.
doi: 10.1007/s40520-023-02474-z. Epub 2023 Jun 19.

Overlapping status of frailty and fear of falling: an elevated risk of incident disability in community-dwelling older adults

Ryuichi Sawa  1   2 , Takehiko Doi  3 , Kota Tsutsumimoto  3 , Sho Nakakubo  3 , Satoshi Kurita  3 , Yuto Kiuchi  3 , Kazuhei Nishimoto  3 , Hiroyuki Shimada  3
Affiliations

Overlapping status of frailty and fear of falling: an elevated risk of incident disability in community-dwelling older adults

Ryuichi Sawa et al. Aging Clin Exp Res. 2023 Sep.

Abstract

Background: Although overlapping frailty and fear of falling (FoF) are likely to increase with population aging, the combined effect of frailty and FoF on incident disability is not yet well understood.

Aims: The purpose of this study is to examine whether frailty combined with FoF increased the risk of incident disability in older adults. Our secondary purpose was to clarify the synergistic effect of frailty and FoF on incident disability.

Methods: This is a prospective study. Participants were 9372 older adults (mean age 73.5 years). Frailty status was assessed using the Japanese Cardiovascular Health Study index, and FoF was measured using two closed questions. Incident disability was prospectively monitored by their long-term care insurance records.

Results: During the follow-up period (mean duration 23.4 months), 487 (5.2%) participants developed disability. The proportion of incident disability linearly increased according to FoF level regardless of baseline frailty status. Frail participants with FoF had a higher risk of incident disability than those with frailty only or neither (adjusted hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.95-3.54). Frailty in combination with excessive FoF further increased the risk of incident disability (adjusted HR 4.30, 95% CI 2.56-7.23) although no synergistic effect was observed (relative excessive risk due to interaction 1.69, 95% CI - 0.55, 3.93).

Conclusion: The overlapping status of frailty and FoF, especially excessive FoF, increases the risk of incident disability in older adults.

Keywords: Disability; Excessive fear; Fear of falling; Frailty; Psychological factor.

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