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Fear of falling assessments in older people with dementia

Published online by Cambridge University Press:  21 May 2015

Chantel Cox  and
Michael Vassallo
Chantel Cox
Affiliation:
The Royal Bournemouth and Christchurch Hospital NHS Foundation Trust, Bournemouth, UK
Michael Vassallo*
Affiliation:
The Royal Bournemouth and Christchurch Hospital NHS Foundation Trust, Bournemouth, UK Bournemouth University, Bournemouth, UK
*
Address for correspondence: Professor Michael Vassallo, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK. Email: Michael.Vassallo@rbch.nhs.uk
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Summary

Fear of falling (FoF) is a common condition in older age. However, there is a paucity of research on its prevalence, impact and treatment in older people with dementia. People with dementia have an increased risk of falls which present a significant threat to their independence, as well as having a significant economic impact on health and social services. This review outlines the key issues in relation to FoF, current guidelines and assessment tools and their use for people with dementia. Further research needs to be completed in both addressing the specific assessment barriers that people with dementia may face regarding the use of current FoF tools, with further exploration surrounding the individual's experience of FoF and how this may be impacting upon their quality of life and functionality. Until a well-validated method has been developed, clinicians need to utilize available tools as guidelines, seek the assistance of proxies at all stages of the care journey, and use clinical judgement to assess FoF in patients with dementia.

Keywords

fear of fallingaccidental fallsageddementia
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 25 , Issue 2 , May 2015 , pp. 98 - 106
Copyright
Copyright © Cambridge University Press 2015 

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References

1 Shaw, F, Bond, J, Richardson, D, Dawson, P, Steen, N, McKeith, I, Kenny, R, Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency apartment: randomised controlled trial. BMJ 2003; 326: 73.Google Scholar
2 Van Dijk, P, Meutenberg, O, Van De Sande, H, Habbema, J. Falls in dementia patients. Gerontologist 1993; 33: 200–4.Google Scholar
3 Oliver, D, Connelly, J, Victor, C et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment. Systematic review and meta-analyses. BMJ 2007; 334: 82–87.Google Scholar
4 Schuffham, P, Chaplin, S, Legood, R. Incidence and cost of unintentional falls in older people in the UK. J Epidemiol Community Health 2003; 57: 740–44.Google Scholar
5 Age, UK. Falls in the over-65s cost NHS £4.6 million a day. Age UK [online] 2010; available at: http://www.ageuk.org.uk/latest-press/archive/falls-over-65s-cost-nhs/ (accessed 12 November 2013).Google Scholar
6 Bhala, RP, O'Donnell, J, Thoppil, E. Ptophobia: phobic fear of falling and its clinical management. Phys Ther 1982; 62: 187–90.Google Scholar
7 Harding, S, Gardener, A. Fear of falling. AJAN 2009; 27: 94–100.Google Scholar
8 Zijlstra, G, van Haastregt, J, van Eijk, J, van Rossum, E. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing 2007; 36: 304–9.Google Scholar
9 Friedman, S, Munoz, B, West, S, Rubin, G, Fried, L. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc 2002; 50: 1329–35.Google Scholar
10 Scheffer, A, Schuurmans, M, Van Dijk, N, Van der Hooft, T, De Rooij, S. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 2008; 37: 19–24.Google Scholar
11 Murphy, J, Isaacs, B. The post-fall syndrome: a study of 36 elderly patients. Gerontology 1982; 28: 265–70.Google Scholar
12 Suzuki, I, Ohyama, N, Yamada, K, Kanamori, M. The relationship between fear of falling, activities of daily living and quality of life among elderly individuals. Nursing and Health Sciences 2002; 4: 155–61.Google Scholar
13 Hotchkiss, A, Fisher, A, Robertson, R, Ruttencutter, A, Schuffert, J, Barker, D. Convergent and predictive validity of three scales related to falls in the elderly. Am J Occup Ther 2004; 58: 100–3.Google Scholar
14 Rochat, S, Büla, C, Martin, E et al. What is the relationship between fear of falling and gait in well-functioning older persons aged 65 to 70 years. Arch Phys Med Rehab 2010; 91: 879–84.Google Scholar
15 Boyd, R, Stevens, J. Falls and fear of falling: burden, beliefs and behaviours. Age Ageing 2009; 38: 423–28.Google Scholar
16 NICE. Clinical guide to falls – Falls: assessment and prevention of falls in older people. 2013. Available at: http://publications.nice.org.uk/falls-assessment-and-prevention-of-falls-in-older-people-cg161 (accessed 16 November 2013).Google Scholar
17 Beyer, L, Hauer, N, Kempen, K, Piot-Ziegler, G, Todd, C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 2005; 34: 614–19.Google Scholar
18 Tinetti, M, Powell, L. Fear of falling and low self-efficacy: a case of dependence in elderly persons. J Gerontol 1993; 48: 35–38.Google Scholar
19 Delbaere, K, Smith, S, Lord, S. Development and initial validation of the Iconographical Falls Efficacy Scale. J Gerontol A Biol Sci Med Sci 2011; 66: 674–80.Google Scholar
20 Ambrose, A, Paul, G, Hausdorff, J. Risk factors for falls among older adults: a review of the literature. Maturitas 2013; 75: 51–61.Google Scholar
21 Deshpande, N, Metter, E, Lauretani, F, Bandinelli, S, Guralnik, J, Ferrucci, L. Activity restriction induced by fear of falling and objective and subjective measures of physical function: a prospective cohort study. J Am Geriatr Soc 2008; 56: 615–20.Google Scholar
22 Fletcher, P, Hirdes, J. Restriction in activity associated with fear of falling among community-based seniors using home care services. Age Ageing 2004; 33: 273–79.Google Scholar
23 Tinetti, M, Richan, D, Powell, L. Falls efficacy as a measure of fear of falling. J Gerontol: B Psychol 1990; 45: P239–43.Google Scholar
24 Myers, A, Powell, L, Maki, B, Holliday, P, Brawley, L, Sherk, W. Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci 1996; 51: M37–43.Google Scholar
25 Donoghue, O, Cronin, H, Savva, G, O'Regan, C, Kenny, RA. Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults. Gait and Posture 2012; 38: 120–24.Google Scholar
26 Clemson, L, Singh, M, Bundy, A. Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ 2012; 345: e4547.Google Scholar
27 Kurrle, S, Brodaty, H, Hogarth, R. Physical Comorbidities of Dementia. Cambridge: Cambridge University Press; 2012.Google Scholar
28 Tinetti, M, Mendes de Leon, C, Doucentte, J, Baler, D. Fear of falling and falls-related falls efficacy in relationship to functioning among community living elders. J Gerontol: Med Sci 1994; 49: M140–47.Google Scholar
29 Ware, J, Gandek, B. Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol 1998; 51: 903–12.Google Scholar
30 Howland, J, Peterson, EW, Levin, WC, Fried, L, Pordon, D, Bak, S. Fear of falling among the community-dwelling elderly. J Aging Health 1993; 5: 229–43.Google Scholar
31 Geschke, K, Fellgiebel, A, Laux, N, Schermuly, I, Scheurich, A. Quality of life in dementia: impact of cognition and insight on applicability of the SF-36. Am J Geriatr Psychiatry 2013; 1: 646–54.Google Scholar
32 Smith, S, Lamping, D, Banerjee, S et al. Measurement of health-related quality of life for people with dementia: development of a new instrument (DEMQOL) and an evaluation of current methodology. Health Technology Assessment 2005; 9: 10.Google Scholar
33 Brod, M, Stewart, A, Sands, L, Walton, P. Conceptualization and measurement of quality of life in dementia: The dementia quality of life instrument (DQoL). Gerontologist 1999; 39: 25–36.Google Scholar
34 Brouwer, B, Musselman, K, Culham, E. Physical function and health status among seniors with and without a fear of falling. Gerontology 2004; 50: 135–41.Google Scholar
35 Nicholson, N. A review of social isolation: an important but underassessed condition in older adults. J Primary Prevention 2012; 33: 137–52.Google Scholar
36 Kendrick, D, Carpenter, H, Morris, R et al. Exercise for reducing fear of falling in older people living in the community (Protocol). Cochrane Database Syst Rev 2014; 11.Google Scholar
37 Yardley, L. Fear of falling: links between inbalance and anxiety. Rev Clin Gerontol 2004; 13: 195–201.Google Scholar
38 Rein Tideiksaar, R. Falling in Old Age: Prevention and Management, 2nd edn. NewYork: Springer Publishing; 1997.Google Scholar
39 Fuzhong, L, John-Fisher, J, Harmer, P, McAuley, E Wilson, N. Fear of falling in elderly persons: association with falls, functional ability, and quality of life. J Gerontol B Psychol Sci Soc Sci 2003; 58: P283–90.Google Scholar
40 Lawrence, R, Tennstedt, S, Kasten, L, Shih, J, Howland, J, Jette, A. Intensity and correlates of fear of falling and hurting oneself in the next year: baseline findings from a Royal Centre fear of falling intervention. J Aging Health 1998; 10: 267–86.Google Scholar
41 Bandura, A. Self-efficacy: The exercise of control. New York: W.H. Freeman; 1997.Google Scholar
42 Myers, A, Powell, L. The Activities-specific Balance Confidence (ABC) Scale. Gerontol A Biol Sci Med Sci 1995; 50A: M28–34.Google Scholar
43 Lachman, M, Howland, J, Tennstedt, S, Jette, A, Assmann, S, Peterson, EW. Fear of falling and activity restriction: the Survey of Activity and the Fear of falling in the Elderly (SAFE). J Gerontol B Psychol Sci Soc Sci 1998; 53: P43–50.Google Scholar
44 Greenberg, S. Analysis of measurement tools of fear of falling for high-risk, community-dwelling older adults. Clin Nursing Res 2012; 21: 113–30.Google Scholar
45 SCIE. Living with dementia [video file]; 24 September 2014. Available at: http://www.scie.org.uk/socialcaretv/video-player.asp?v=living-with-dementia Google Scholar
46 Puisieux, F, Pardessus, V, Bombois, S. Dementia and falls: two related syndromes in old age. Psychol Neuropsychiatr Vieil 2005; 3: 271–79.Google Scholar
47 Denkinger, M, Wilmar, I, Lukas, A et al. Relationship between fear of falling and outcomes of an inpatient geriatric rehabilitation population – fear of the fear of falling. J Am Geriatr Soc 2010; 58: 664–73.Google Scholar
48 Schwenk, M, Hauer, K, Zieschang, T, Englert, S, Mohler, J, Najafi, B. Sensor-derived physical activity parameters can predict future falls in people with dementia. Gerontology 2014; 60: 483–92.Google Scholar
49 Wesson, J, Clemson, L, Brodaty, H et al. A feasibility study and pilot randomised trial of a tailored prevention programme to reduce falls in older people with mild dementia. BMC Geriatrics 2013; 13: 89.Google Scholar
50 Hauer, K, Yardley, L, Beyer, N et al. Validation of the Falls Efficacy Scale and Falls Efficacy Scale International in geriatric patients with and without cognitive impairment: results of self-report and interview based questionnaires. Gerontology 2010; 26: 190–99.Google Scholar
51 Hauer, K, Kempen, G, Schwenk, M et al. Validity and sensitivity to change of the Falls Efficacy Scales International to assess fear of falling in older adults with and without cognitive impairment. Gerontology 2011; 57: 462–72.Google Scholar
52 Faesa, M, Reelicka, M, Joosten-Weyn Banninghab, L et al. Qualitative study on the impact of falling in frail older persons and family caregivers: foundations for an intervention to prevent falls. Ageing Mental Health 2010; 14: 834–42.Google Scholar
53 Delbaere, K, Close, J, Taylor, M, Wesson, J, Lord, S. Validation of the Iconographical Falls Efficacy Scale in cognitively impaired older people. J Gerontol A Biol Sci Med 2013; 68: 1098–102.Google Scholar
54 Rankin, K, Baldwin, E, Pace-Savitsky, C, Kramer, J, Miller, B. Self-awareness and personality change in dementia. J Neurol Neurosurg Psychiatry 2005; 76: 632–39.Google Scholar
55 Griffiths, F, Mason, V, Boardman, F et al. Evaluating recovery following hip fracture: a qualitative interview study of what is important to patients. BMJ 2015; 5: 1–10.Google Scholar
56 Frampton, M. Experience assessment and management of pain in people with dementia. Age Ageing 2003; 32: 248–51.Google Scholar
57 Morrison, S, Siu, AL. A comparison of pain and its treatment in advanced dementia and cognitively intact patients with hip fracture. J Pain Symptom Manage 2000; 19: 240–48.Google Scholar
58 Weiner, D, Hanlon, J. Pain in nursing home residents: management strategies. Drugs Ageing 2001; 18: 13–29.Google Scholar
59 Scherder, E, Bouma, A. Is decreased use of analgesics in Alzheimer disease due to a change in the affective component of pain? Alzheimer Dis Assoc Disord 1997; 11: 171–74.Google Scholar
60 Horgas, A, Miller, L. Pain assessment in people with dementia. AJN 2008; 108: 62–70.Google Scholar
61 Gillespie, L, Robertson, M, Gillespie, W, Lamb, S, Gates, S, Cumming, R, Rowe, B. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2009; 15 (2): CD007146.Google Scholar
62 Gillespie, L, Robertson, M, Gillespie, W, Sherrington, C, Gates, S, Clemson, L, Lamb, S. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012; 12 (9): CD007146.Google Scholar
63 Jensen, L, Padilla, L. Effectiveness of interventions to prevent falls in people with Alzheimer's disease and related dementias. Am J Occup Ther 2011; 65: 532–40.Google Scholar
64 Delbaere, K, Close, J, Brodaty, H, Sachdev, P, Lord, S. Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. BMJ 2010; 341: c4165.Google Scholar
65 Brouwer, B, Walker, C, Rydahl, S, Culham, E. Reducing fear of falling in seniors through education and activity programs: a randomized trial. J Am Geriatr Soc 2003; 51: 829–34.Google Scholar
66 Zijlstra, G, Van Haastregt, J, Ambergen, T et al. Effects of a multicomponent cognitive behavioral group intervention on fear of falling and activity avoidance in community-dwelling older adults: results of a randomized controlled trial. J Am Geriatr Soc 2009; 57: 2020–28.Google Scholar
67 Cumming, R, Salkeld, G, Thomas, M, Szonyi, G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci 2000; 55: 299–305.Google Scholar