Falls, Fear of Falling, and Activity Avoidance due to Fear of Falling among Thai Community-dwelling Older Adults living in Suburban Chiang Mai Thailand

Main Article Content

Sutthida Phongphanngam
Ampicha Nawai

Abstract

This cross-sectional descriptive study aimed to: (1) examine the prevalence of falls, fear of falling, and activity avoidance due to fear of falling; and (2) investigate factors correlated to falls and fear of falling in Thai community-dwelling older adults living in suburban Chiang Mai.
Participants were 142 adults aged 60 years and over who volunteered to participate in the study. Data were collected using interview. Instruments included demographic questionnaires, a Mini-Mental State Examination-Thai, history of falls, the Fear of Falling Rating Scale, the Fear
of Falling Questionnaire, the Falls Efficacy Scale-International, the Center for Epidemiology Studies Depression Scale, the Geriatric Anxiety Scale-Ten-item, and the Short Physical Performance Battery (SPPB). Descriptive statistics (univariate and multivariate binary logistic regression) were
used to analyze data. Most participants were female (73.90%) with a mean age of 70.69 years (SD. = 7.44). About 32.60% of participants reported that they had fallen in the previous years. Most of the participants reported that they had fear of falling (76.10%) and 58.50% of participants reported that they had restricted their activities owing to fear of falling. Multivariate binary logistic regression revealed that a model containing visual impairment, fear of falling, and number of medications used was statistically significantly associated with falling and could explain 73.40% [X2(4, n = 139) = 14.96, p<.01] of the variance in falling. Only fear of falling (B = -1.28, p<.01) had a statistically significant contribution to the model. In terms of fear of falling, it was found that a model composed of females, having a history of falls in the previous years, having anxiety, and having high level of SPPB could explain 80.1% [X2 (4, n = 141) = 22.80, p<.01] of the variance in fear of falling. Each
of the variables, female (B = 1.30, p<.01), having a history of falls in the previous years (B = -1.47, p<.01), and having anxiety (B = 1.31, p<.05) had statistically significant contributions to the model. The results of this study might be used as a guideline to assess factors related to falls and fear
of fall, and to design a program to prevent falls and reduce fear of falling among older adults
living in suburban areas.

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How to Cite
Phongphanngam, S., & Nawai, A. (2020). Falls, Fear of Falling, and Activity Avoidance due to Fear of Falling among Thai Community-dwelling Older Adults living in Suburban Chiang Mai Thailand. Journal of Health and Nursing Research (Journal of Boromarajonani College of Nursing, Bangkok), 36(1), 22-38. Retrieved from https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/242136
Section
Research articles

References

1. Zhao YL, Alderden J, Lind B, Stibrany J. Risk factors for falls in homebound community-dwelling older adults. Public Health Nurs. 2019;36(6):772-8.

2. Pitchai P, Dedhia HB, Bhandari N, Krishnan D, D'Souza NRJ, Bellara JM. Prevalence, risk factors, circumstances for falls and level of functional independence among geriatric population - A descriptive study. Indian J Public Health. 2019;63(1):21-6.

3. Jung D, Kang Y, Kim MY, Ma RW, Bhandari P. Zero-inflated poisson modeling of fall risk factors in community-dwelling older adults. West J Nurs Res. 2016;38(2):231-47.

4. Cheng MH, Chang SF. Frailty as a risk factor for falls among community dwelling people: evidence from a meta-analysis. J Nurs Scholarsh. 2017;49(5):529-36.

5. Canada B, Stephan Y, Sutin A, Terracciano A. Personality and falls among older adults: evidence from a longitudinal cohort. J Gerontol B Psychol Sci Soc Sci. 2019;xx(xx):1-6. doi:10.1093/geronb/gbz040.

6. Li FF, Zhou DD, Ye ZF, Ren J, Xue C, Peng JJ, et al. Epidemiologic characteristics of fall in the elderly in urban and rural areas in Shanghai. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi. 2019;40(7):779-85.

7. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21(5):658-68.

8. Kwan MMS, Close JCT, Wong AKW, Lord SR. Falls incidence, risk factors, and consequences in Chinese older people: A systematic review. J Am Geriatr Soc. 2011;59(3):536-43.

9. Do MT, Chang VC, Kuran N, Thompson W. Fall-related injuries among Canadian seniors, 2005-2013: an analysis of the Canadian Community Health Survey. Health promotion and chronic disease prevention in Canada : research, policy and practice. 2015;35(7):99-108.

10. Choi NG, Choi BY, DiNitto DM, Marti CN, Kunik ME. Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics. BMC Geriatr. 2019;19(1):303.

11. Peeters GM, Jones M, Byles J, Dobson AJ. Long-term consequences of noninjurious and injurious falls on well-being in older women. J Gerontol A Biol Sci Med Sci. 2015;70(12):1519-25.

12. Chang NT, Yang NP, Chou P. Incidence, risk factors and consequences of falling injuries among the community-dwelling elderly in Shihpai, Taiwan. Aging Clin Exp Res. 2010;22(1):70-7.

13. Lavedan A, Viladrosa M. Fear of falling in community-dwelling older adults: a cause of falls, a consequence, or both? 2018;13(3):e0194967. doi: 10.1371/journal.pone.019496.

14. Rivasi G, Kenny RA, Ungar A, Romero-Ortuno R. Predictors of incident fear of falling in community-dwelling older adults. J Am Med Dir Assoc. 2019. doi: 10.1016/j.jamda.2019.08.020.

15. Cho H, Seol SJ, Yoon DH, Kim MJ, Choi BY, Kim T. Disparity in the fear of falling between urban and rural residents in relation with socio-economic variables, health issues, and functional independency. Annals of rehabilitation medicine. 2013;37(6):848-61.

16. Worapanwisit T, Prabpai S, Rosenberg E. Correlates of Falls among community-dwelling elderly in Thailand. Journal of aging research. 2018;2018:8546085. doi: 10.1155/2018/8546085.

17. Boonpleng W, Sriwongwan W, Sattawatcharawanij P. Rate and associated factors for falls among elderly people: chaopraya waterfront community in Nonthaburi Province. Journal of Nursing Science. 2015;33(3):74-86.

18. Sophonratanapokin B, Sawangdee Y, Soonthorndhada K. Effect of the living environment on falls among the elderly in Thailand. Southeast Asian J Trop Med Public Health. 2012;43(6):1537-47.

19. Phongphanngam S, Lach HW, Phomkaewngam S, Chantawang S. Measuring fear of falling in thai community-dwelling older adults with a new measure Boromarajonani. College of Nursing, Uttaradit Journal 2019;11(2):229-44.

20. Rongmuang D, Chantana Nakchattri C, Jeeraporn Tongdee JJS. Incidence and factors associated with fall among the community-dwelling elderly, Suratthani. Journal of Phrapokklao Nursing College. 2016;27(Suppl. 1):1-12. (in Thai).

21. Thiamwong L, Suwanno J. Fear of falling and related factors in a community-based study of people 60 years and older in Thailand. Int J Gerontol. 2017;11:80-4. doi: https://doi.org/10.1016/j.ijge.2016.06.003.

22. Kuhirunyaratn P, Prasomrak P, Jindawong B. Factors related to falls among community dwelling elderly. Southeast Asian J Trop Med Public Health. 2013;44(5):906-15.

23. Phongphanngam S. Fear of falling and disability among Thai communitt-dwelling older adults (Unpublished Dissertation): Saint Louis University School of Nursing; 2015.

24. Ngudgratoke S. Data collection and data management process. 2016. [cited 2019 Dec 27]. Available from: http://www.priv.nrct.go.th/ewt_dl.php?nid = 1434. (in Thai).

25. Tabachnick BG, Fidell LS. Using multivariate statistics. 6th eds. Boston: Perason; 2013.

26. Institute of Geriatric Medicine. Mini Mental State Examination-Thai version, MMSE-Thai 2002. Nonthaburi: Institute of Geriatric Medicine; 2002. (in Thai).

27. Dayhoff NE, Baird C, Bennett S, Backer J. Fear of falling: measuring fear and appraisals of potential harm. Rehabilitation Nursing Research. 1994;3(3):97-104.

28. Noimontree W, Lach HW, editors. Development of a Short Version of the Fear of Falling Questionnaire (Short-FFQ). 23th Annual Graduate Student Association Research Symposium; 2017;. Saint Louis University.

29. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34(6):614-9.

30. Phongphanngam S, Lach HW. Cross-cultural Instrument Translation and Adaptation: Challenges and Strategies. Pacific Rim International Journal of Nursing Research. 2019;23(2):170-9.

31. Radloff LS. The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385-401.

32. Vorapongsathron T, Pandii W, Traimchaisri T. A validity study of the Center for Epidemiology Studies Depression Scale. J Clin Psychol. 1990;21:26-45. (in Thai).

33. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77-84.

34. Mueller AE, Segal DL, Gavett B, Marty MA, Yochim B, June A, et al. Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). Int Psychogeriatr. 2015;27(7):1099-111.

35. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.

36. Lusardi MM, Fritz S, Middleton A, Allison L, Wingood M, Phillips E, et al. Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability. J Geriatr Phys Ther. 2017;40(1):1-36.

37. Mortazavi H, Tabatabaeichehr M, Taherpour M, Masoumi M. Relationship Between Home Safety and Prevalence of Falls and Fear of Falling Among Elderly People: a Cross-sectional Study. Materia socio-medica. 2018;30(2):103-7.

38. Chippendale T, Boltz M. The neighborhood environment: Perceived fall risk, resources, and strategies for fall prevention. Gerontologist. 2015;55(4):575-83.

39. Choi K, Ko Y. Characteristics Associated With Fear of Falling and Activity Restriction in South Korean Older Adults. J Aging Health. 2015;27(6):1066-83.

40. Pholin T, Jitramontree N, Wirojratana V. The Relationships between Personal Factors, Health Status, Fear of Falling, and Fall Preventive Behaviors of Community Dwelling Older Persons. Journal of Nursing Science Chulalongkorn University 2017;29(1):36-50. (in Thai).

41. Souza AQ, Pegorari MS, Nascimento JS, Oliveira PB, Tavares D. Incidence and predictive factors of falls in community-dwelling elderly: a longitudinal study. Ciencia & saude coletiva. 2019;24(9):3507-16.