Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T05:14:28.087Z Has data issue: false hasContentIssue false

Fear of Falling among Elderly Patients with Dizziness and Syncope in a Tilt Setting

Published online by Cambridge University Press:  01 June 2009

Javier Perez-Jara*
Affiliation:
Unidad de Valoracion Geriatrica, Hospital del Bierzo, Ponferrada, Leon, Spain
Alfredo Enguix
Affiliation:
Servicio de Analisis Clinicos, Hospital Carmen y Severo Ochoa, Cangas de Narcea, Asturias, Spain
Jose Miguel Fernandez-Quintas
Affiliation:
Servicio de Atención Primaria, Centro de Salud Ponferrada II, Ponferrada, Leon, Spain
Beatriz Gómez-Salvador
Affiliation:
Servicio de Atención Primaria, Centro de Salud Ponferrada II, Ponferrada, Leon, Spain
Rosa Baz
Affiliation:
Servicio de Atención Primaria, Centro de Salud Ponferrada II, Ponferrada, Leon, Spain
Paloma Olmos
Affiliation:
Servicio de Atención Primaria, Centro de Salud Ponferrada II, Ponferrada, Leon, Spain
Alberto Rodríguez
Affiliation:
Servicio de Atención Primaria, Centro de Salud Ponferrada II, Ponferrada, Leon, Spain
Arturo Vilches
Affiliation:
Sección de Geriatria, Hospital Meixoeiro, Complejo Universitario de Vigo, Spain
Carlos Reyes-Ortiz
Affiliation:
Department of Social & Behavioral Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA.
*
*Correspondence to: / Correspondance à : Javier Perez-Jara Unidad de Valoración Geriátrica Hospital El Bierzo C/ Medicos sin Fronteras s/n Ponferrada, Leon, 24411, Spain Telephone: 0034987455200 ext 266 Fax: 0034987455300 E-mail: jperezjara@wanadoo.es

Abstract

The objectives of this study were to assess the prevalence of fear of falling (FOF) among patients over age 60 with dizziness, falls, or syncope; and to analyze risk factors associated with FOF, including data from the tilt table test. This study included 200 older patients referred to a geriatric outpatient clinic specializing in dizziness, falls, and syncope. The primary outcome measure was the proportion of patients who experienced FOF (yes vs. no) and whether FOF restricted leaving home alone or performing activities of daily living. FOF occurred in 50 per cent of patients in this population. Among these, 44 per cent gave up going out alone and 10 per cent stopped doing basic activities of daily living. Beyond age 75, FOF was associated with recurrent dizziness, depression, and symptoms on standing, but not prior falls.

Résumé

Les objectifs de cette étude étaient de mesurer la prévalence de la crainte de tomber chez les patients âgés de plus de 60 ans à cause d’étourdissements, de chutes et de syncopes et d’analyser les facteurs de risque que l’on associe à ce syndrome, y compris les données provenant du test d’inclinaison. Cette étude transversale a inclus 200 patients qui ont été dirigés vers une clinique gériatrique externe spécialisée dans les étourdissements, les chutes et les syncopes. Le premier résultat mesuré a été la proportion de patients qui ont expérimenté la crainte de tomber (oui ou non) et si cette crainte causait une restriction au moment de sortir seuls ou d’effectuer les activités de la vie quotidienne. La crainte de tomber est apparue chez 50 pour cent des patients de cette population. Parmi eux, 44 pour cent avaient cessé de sortir seuls et 10 pour cent avaient cessé d’effectuer les activités de base de la vie quotidienne. Chez les patients de 75 ans et plus, les étourdissements à répétition, la dépression et les symptômes ressentis lorsqu’ils se lèvent ont été des facteurs associés à la crainte de tomber. Le fait d’avoir subi des chutes au préalable n’a pas été un facteur associé.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Myers, AM, Powell, LE, Maki, BE, Holliday, PJ, Brawley, LR, Sherk, W. Psychological indicators of balance confidence relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci 1996;51A(1):M37–43.CrossRefGoogle Scholar
2.Howland, J, Walker, E, Levin, WC, Fried, L, Pordon, D, Bak, S. Fear of falling among the community-dwelling elderly. J Ageing and Health 1993 May;5(2):229–43.Google Scholar
3.Howland, J, Lachman, ME, Peterson, EW, Cote, J, Kasten, L, Jette, A. Covariates of fear of falling an associated activity curtailment. Gerontologist 1998;38(5):549–55.Google Scholar
4.Lawrence, RH, Tennstedt, SL, Kasten, LE, Shih, J, Howland, J, Jette, AM. Intensity and correlates of fear of falling and hurting oneself in the next year: baseline findings from a Roybal Center fear of falling intervention. J Aging Health 1998;10(3):267–86.Google Scholar
5.Lachman, ME, Howland, J, Tennstedt, S, Jette, A, Assmann, S, Peterson, EW. Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). J Gerontol B Psychol Sci Soc Sci 1998 Jan;53(1):P43–50.CrossRefGoogle Scholar
6.Vellas, BJ, Wayne, SJ, Romero, LJ, Baumgartner, RN, Garry, PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing 1997;26:189–93.Google Scholar
7.Tinetti, ME, Mendes de Leon, CF, Doucette, JT, Baker, DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol A Biol Sci Med Sci 1994;49:M140–7.Google Scholar
8.Burker, EJ, Wong, H, Sloane, PD, Mattingly, D, Preisser, J, Mitchell, CM. Predictors of fear of falling in dizzy and nondizzy elderly. Psychol Aging 1995 Mar;10(1):104–10.Google Scholar
9.Aoyagi, K, Ross, PD, Davis, JW, Wasnich, RD, Hayashi, T, Takemoto, T. Falls among community-dwelling elderly in Japan. J Bone Miner Res 1998 Sep;13(9):1468–74Google Scholar
10.Legters, K. Fear of falling. Phys Ther 2002 Mar;82:264–72.CrossRefGoogle ScholarPubMed
11.Pfeiffer, E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 1975 Oct;23(10):433–41.Google Scholar
12.Sheik, JL,Yesavage, JA. Geriatric depression scales: recent evidence and development of a shorter version. Clin Gerontol 1986;5:165–73.Google Scholar
13.Kenny, R, O’Shea, D, Parry, S. The Newcastle protocols for head-up tilt table testing in the diagnosis of vasovagal syncope, carotid sinus hypersensitivity, and related disorders. Heart 2000 May;83(5):564–69.Google Scholar
14.Tinetti, ME, Richman, D, Powell, L. Falls efficacy as a measure of fear of falling. J Gerontol B Psychol Sci Soc Sci 1990;45:239–43.Google ScholarPubMed
15.Hill, KD, Schwarz, JA, Kelogeropoulos, AJ, Gibson, SJ. Fear of falling revisited. Arch Phys Med Rehabil 1996;77:1025–9.CrossRefGoogle ScholarPubMed
16.Powell, LE, Myers, AM. The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci 1995;50:M28–34.Google Scholar
17.Shumway-Cook, A, Gruber, W, Baldwin, M, Liao, S. The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. Phys Ther 1997;77:46–57.Google Scholar
18.Franzoni, S, Rozzini, R, Boffelli, S, Frisoni, GB, Trabucchi, M. Fear of falling in nursing home patients. Gerontology 1994;40:38–44.CrossRefGoogle ScholarPubMed
19.Arfken, CL, Lach, HW, Birge, SJ, Miller, JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health 1994 Apr;84(4):565–70.Google Scholar
20.Cumming, RG, 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 May;55A(5):M299–05.Google Scholar
21.Evitt, CP, Quigley, PA. Fear of falling in older adults: a guide to its prevalence, risk factors and consequences. Rehabil Nurs 2004 Nov-Dec;29(6): 207–10.Google Scholar
22.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 Nov;34(6):614–9.Google Scholar
23.Kressig, RW, Wolf, SL, Sattin, RW, O’Grade, M, Greenspan, A, Curns, A et al. Associations of demographic, functional and behavioral characteristics with activity-related fear of falling among older adults transitioning to frailty. J Am Geriatr Soc 2001 Nov;49:1456–62.CrossRefGoogle ScholarPubMed
24.Gagnon, N, Flint, AJ, Naglie, G, Devins, GM. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry 2005 Jan;13(1):7–14.Google Scholar
25.Austin, N, Devine, A, Dick, I, Prince, R, Bruce, D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc 2007 Oct;55(10):1598–603.CrossRefGoogle ScholarPubMed
26.Rosso-Henao, V, Reyes-Ortiz, CA, Gómez, F, Curcio, CL, Ottenbacher, KJ, Markides, KS. The temporal relationship between falls and fear of falling among older Mexican Americans (abstract). J Am Geriatr Soc 2007;55 Suppl :S195.Google Scholar
27.Bischoff, HA, Stähelin, HB, Dick, W, Akos, R, Knecht, M, Salis, C et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 2003 Feb;18(2):343–51.CrossRefGoogle ScholarPubMed
28.Gonzalez, EA, Sachdeva, A, Oliver, DA, Martin, KJ. Vitamin D insufficiency and deficiency in chronic kidney disease. A single center observational study. Am J Nephrol 2004 Sep-Oct;24(5):503–10.Google Scholar
29.Heiwe, S, Dahlgren, MA. Living with chronic renal failure: coping with physical activities of daily living. Advances in Physiotherapy 2004;6(4):147–157.Google Scholar