Abstract

Objective

To evaluate the use of an assessment of fear of falling (i.e., Short Fall Efficacy Scale [SFES]) in the evaluation and management of mild traumatic brain injury (mTBI) in older adults.

Methods

Fifty-two older adults (40% male) aged 60–76 (66.44 ± 4.74) years were included in the study; 27 older adults diagnosed with mTBI within three months of injury (33.07 ± 18.86 days) and 25 age-group and sex-matched controls. All participants completed the SFES, Vestibular/Ocular-Motor Screening (VOMS), Post-Concussion Symptom Scale (PCSS), Generalized Anxiety Disorder- 7 Item (GAD-7), and Geriatric Depression Scale- 5 Item (GDS5). Statistical comparisons were performed using paired t-tests and Pearson correlations.

Results

There were no significant differences on demographic factors, with the exception of participants in the mTBI group being more likely to have a history of a sleep disorder (χ2 = 10.26, p = 0.001). T-tests revealed higher concern for falling on SFES and higher total symptoms on the VOMS, GAD-7, and PCSS (p < 0.01) in mTBI versus controls. Those with mTBI who sustained a fall, compared to other mechanisms of injury, did not differ in their report of fear of falling post-injury (p = 0.74). SFES scores were moderately correlated with VOMS total score (r = 0.40, p < 0.01), PCSS total score (r = 0.64, p < 0.01), GAD-7 (r = 0.65, p < 0.01), and GDS-5 (r = 0.60, p < 0.05).

Conclusions

Older adults with mTBI endorse greater fear of falling on the SFES and more symptoms on mTBI assessment tools relative to healthy controls. Future studies should include objective measures of balance to evaluate the relationship between fear of falling and postural stability.

中文翻译：

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A-17患有mTBI的老年人跌倒的恐惧

摘要

客观的

为了评估在对老年人轻度颅脑损伤（mTBI）的评估和管理中对跌倒恐惧的评估（即短期跌倒效能量表[SFES]）的使用。

方法

该研究包括52名年龄在60-76岁（66.44±4.74）岁的成年人（男性占40％）；27名在受伤三个月内（33.07±18.86天）被诊断出患有mTBI的成年人和25名年龄和性别匹配的对照组。所有参与者均完成了SFES，前庭/眼动筛查（VOMS），脑震荡后症状量表（PCSS），广泛性焦虑障碍-7项目（GAD-7）和老年抑郁量表-5项目（GDS5）。使用配对t检验和Pearson相关进行统计比较。

结果

人口统计学因素无显着差异，除了mTBI组的参与者更有可能患有睡眠障碍史（χ2= 10.26，p = 0.001）。T检验显示，与对照组相比，mTBI对SFES下降的担忧更高，对VOMS，GAD-7和PCSS的总体症状也更高（p <0.01）。与其他损伤机制相比，患有mTBI的患者跌倒的报告在担心受伤后跌倒的报告中没有差异（p = 0.74）。SFES评分与VOMS总评分（r = 0.40，p <0.01），PCSS总评分（r = 0.64，p <0.01），GAD-7（r = 0.65，p <0.01）和GDS-5（ r = 0.60，p <0.05）。

结论

相对于健康对照组，患有mTBI的老年人更倾向于害怕跌落SFES，并且在mTBI评估工具上出现更多症状。未来的研究应包括客观的平衡措施，以评估对跌倒的恐惧与姿势稳定之间的关系。