Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan

BackgroundFear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored.ObjectivesTo explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan.MethodsThis community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-to-face interviews.ResultsA total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling.ConclusionsFear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people.

研究背景 跌倒恐惧（fear of falling）是老年人群不良健康相关结局的重要风险指标。然而，社区居住老年人群中与跌倒恐惧相关的影响因素尚未得到充分探索。
研究目的 探讨中国台湾地区石牌地区老年人群的跌倒恐惧相关生活质量及其影响因素。
研究方法 本项基于社区的调查共招募3824名年龄≥65岁的老年受试者。研究通过面对面访谈方式收集数据，所用调研工具为结构化问卷，其中生活质量评估采用简明健康调查问卷（Short-Form 36），同时采集跌倒恐惧、既往跌倒史、人口学特征、基础疾病状况、失眠、睡眠质量、抑郁状况及主观健康水平等相关信息。
研究结果 共有53.4%的受试者报告存在跌倒恐惧。女性受试者的跌倒恐惧报告率更高。无论男性还是女性，存在跌倒恐惧的受试者其简明健康调查问卷得分均更低。既往1年跌倒史、高龄、失眠、抑郁及主观健康状况较差是两类性别群体共有的跌倒恐惧相关影响因素。男性群体中，急诊医疗可及性、糖尿病（diabetes mellitus）、卒中（stroke）为跌倒恐惧的特异性相关因素；而女性群体中，心血管疾病（cardiovascular diseases）则为跌倒恐惧的特异性相关因素。
研究结论 社区居住老年人群中跌倒恐惧普遍存在。研究显示，老年人群在跌倒恐惧的流行率及其影响因素方面存在性别差异。在制定老年人群跌倒恐惧的预防与干预策略时，应充分考虑性别差异因素。