Associations of Frailty, Concerns About Falling, and Fall Risk in Community-Dwelling Older Adults in Orlando, Florida: A Preliminary Analysis

Abstract

Objectives: This study examines relationships between frailty, concerns about falling (CaF), and fall risk in community-dwelling older adults (≥60 years old).

Methods: Frailty, CaF, and fall risk were cross-sectionally assessed using the FRAIL, short FES-I, and STEADI questionnaires in 178 participants. Spearman correlations, logistical regression, and ordinal regression analysis were performed.

Results: 38.2% of participants were robust, 48.9% pre-frail, and 12.9% frail. Logistic regressions revealed that frail individuals were 91.4% more likely to have CaF compared to non-frail individuals, and individuals with lower fall risk were 5.7 times less likely to have CaF than those with no fall risk. Pre-frail individuals were more likely to have fall risk than non-frail individuals. Individuals with low CaF were 6 times less likely to have fall risk than those with high CaF. Ordinal logistic regressions revealed that for individuals with no CaF and no fall risk, the odds of being frail were 69.5% and 86.7% lower, respectively, than those with high CaF and high fall risk.

Conclusions: Frailty relationships with fall risk and CaF indicate the importance of addressing frailty to aid in fall prevention in older adults. Further, addressing the CaF mentality is important in fall prevention in older adults. ClinicalTrials.gov ID: NCT05778604.

Keywords: Community; Concerns about falling; Fall risk; Frailty; Older adults.

Figure 1

Spearman correlations comparing FRAIL Score vs. STEADI Score (A) and FRAIL Score vs. Short-FES-I Score (B). Significance was set to p<0.05. P-values and correlation coefficients (r-values) are displayed in the bottom right-hand corner of each figure.

Figure 2

Spearman correlation comparing STEADI Score vs. Short-FES-I Score. Significance was set to p<0.05. P-values and correlation coefficients are displayed in the bottom right-hand corner of each figure.

Figure 3

Spearman correlations comparing components of the STEADI questionnaire with FRAIL Score and Short FES-I Score. (A) shows the comparison of the STEADI question, “I am worried about falling” and the Short FES-I Score. (B) shows the comparison of “Balance Confidence” and FRAIL Score, and (C) shows the comparison of “Balance Confidence” and Short FES-I Score. “Balance Confidence” was determined by the combination of the STEADI questions. “Sometimes I feel unsteady when I am walking” and “I steady myself by holding onto furniture when walking at home.” For “I am worried about falling,” a score of 1 is “No,” and a score of 2 is “Yes.” For “Balance Confidence,” scores range from 2-4, where a “No” for each question is a score of 2, and a “Yes” for each question is a score of 4. Significance was set to p<0.05. P-values and correlation coefficients (r-values) are displayed in the bottom right-hand corner of each figure.