Balance Self-Efficacy Predicts Risk Factors for Side Falls and Frequent Falls in Community-Dwelling Elderly

This study assessed changes in balance self-efficacy (BSE) over 1 year in community-dwelling elderly, compared changes in BSE between fallers and nonfallers, and assessed the relationship between specific balance and mobility risk factors for side falls and BSE scores. Elderly fallers (n = 67; 80.2 ± 5.9 years) and nonfallers (n = 75; 79.4 ± 4.9), categorized based on self-reported falls over 1 year, were tested at baseline on postural sway, hip-abduction strength, lateral-stepping velocity, tandem walk, and get-up-and-go and given a BSE questionnaire. Fallers had lower BSE scores than nonfallers did (141.6 ± 33.5 and 154.9 ± 25.4; p = .008). BSE did not change over 1 year. In stepwise regression, BSE scores were predictive of time on the get-up-and-go, mediolateral sway, and tandem walk independent of age, height, and strength (p < .001). The BSE scale might be useful for screening individuals at risk for injurious falls because it is inexpensive and noninvasive.

[1]  P J Holliday,et al.  Psychological indicators of balance confidence: relationship to actual and perceived abilities. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[2]  R. Baumgartner,et al.  Fear of falling and restriction of mobility in elderly fallers. , 1997, Age and ageing.

[3]  L. Lipsitz,et al.  High-intensity strength training in nonagenarians. Effects on skeletal muscle. , 1990, JAMA.

[4]  R. Cumming,et al.  Quality of life related to fear of falling and hip fracture in older women: a time trade off study. , 2000, BMJ.

[5]  L. E. Powell,et al.  The Activities-specific Balance Confidence (ABC) Scale. , 1995, The journals of gerontology. Series A, Biological sciences and medical sciences.

[6]  W C Hayes,et al.  Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. , 1994, JAMA.

[7]  M. Tinetti,et al.  Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. , 1994, Journal of gerontology.

[8]  A. Bandura Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[9]  C. Velozo,et al.  Developing Meaningful Fear of Falling Measures for Community Dwelling Elderly , 2001, American journal of physical medicine & rehabilitation.

[10]  B. E. Maki,et al.  Gait Changes in Older Adults: Predictors of Falls or Indicators of Fear? , 1997, Journal of the American Geriatrics Society.

[11]  M. Tinetti,et al.  Risk factors for falls among elderly persons living in the community. , 1988, The New England journal of medicine.

[12]  W. Hayes,et al.  Impact near the hip dominates fracture risk in elderly nursing home residents who fall , 1993, Calcified Tissue International.

[13]  P. Laippala,et al.  Factors Predicting Fractures During Falling Impacts Among Home‐Dwelling Older Adults , 1997, Journal of the American Geriatrics Society.

[14]  W C Hayes,et al.  Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. , 1998, The American journal of medicine.

[15]  B. Vellas,et al.  Prospective study of restriction of activity in old people after falls. , 1987, Age and ageing.

[16]  M. Tinetti,et al.  Falls efficacy as a measure of fear of falling. , 1990, Journal of gerontology.

[17]  W. Hayes,et al.  Functional mobility discriminates nonfallers from one-time and frequent fallers. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[18]  A M Dellinger,et al.  Surveillance for injuries and violence among older adults. , 1999, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[19]  R G Cumming,et al.  Epidemiology of Medication-Related Falls and Fractures in the Elderly , 1998, Drugs & aging.

[20]  B. E. Maki,et al.  Fear of falling and postural performance in the elderly. , 1991, Journal of gerontology.

[21]  R. Cumming,et al.  Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[22]  D. Buchner,et al.  Reliability of physical performance measures in nursing home residents with Alzheimer's disease. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[23]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.