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Fear of falling and all-cause mortality among young-old community-dwelling adults: a 6-year prospective study
European Journal of Ageing ( IF 3.721 ) Pub Date : 2021-07-03 , DOI: 10.1007/s10433-021-00635-5
Giulia Belloni 1, 2 , Christophe Büla 1 , Brigitte Santos-Eggimann 2 , Yves Henchoz 2 , Sarah Fustinoni 2 , Laurence Seematter-Bagnoud 1, 2
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This study investigated whether fear of falling (FOF) measured by two different instruments, the Falls Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction (SQ-FAR), is associated with mortality at 6-year follow-up. Participants (n = 1359, 58.6% women) were community-dwelling persons enrolled in the Lausanne cohort 65 + , aged 66 to 71 years at baseline. Covariables assessed at baseline included demographic, cognitive, affective, functional and health status, while date of death was obtained from the office in charge for population registration. Unadjusted Kaplan Meyer curves were performed to show the survival probability for all-cause mortality according to the degree of FOF reported with FES-I and SQ-FAR, respectively. Bivariable and multivariable Cox regression analyses were performed to assess hazard ratios, using time-in-study as the time scale variable and adjusting for variables significantly associated in bivariable analyses. During the 6-year follow-up, 102 (7.5%) participants died. Reporting the highest level of fear at FES-I (crude HR 3.86, 95% CI 2.37–6.29, P < .001) or “FOF with activity restriction” with SQ-FAR (crude HR 2.42, 95% CI 1.44-4.09, P = .001) were both associated with increased hazard of death but these associations did not remain significant once adjusting for gender, cognitive, affective and functional status. As a conclusion, although high FOF and related activity restriction, assessed with FES-I and SQ-FAR, identifies young-old community-dwelling people at increased risk of 6-year mortality, this association disappears when adjusting for potential confounders. As a marker of negative health outcomes, FOF should be screened for in order to provide personalized care and reduce subsequent risks.



中文翻译:

社区居住的年轻老年人对跌倒的恐惧和全因死亡率:一项为期 6 年的前瞻性研究

本研究调查了通过两种不同的工具——国际跌倒功效量表(FES-I)和关于 FOF 和活动限制的单一问题(SQ-FAR)——测量的对跌倒的恐惧 (FOF) 是否与 6 年死亡率相关。跟进。参与者(n  = 1359,58.6% 为女性)是洛桑队列 65 岁以上的社区居民,基线年龄为 66 至 71 岁。基线评估的协变量包括人口、认知、情感、功能和健康状况,而死亡日期是从负责人口登记的办公室获得的。未调整的 Kaplan Meyer 曲线根据分别用 FES-I 和 SQ-FAR 报告的 FOF 程度显示全因死亡率的生存概率。采用双变量和多变量 Cox 回归分析来评估风险比,使用研究时间作为时间尺度变量,并对双变量分析中显着相关的变量进行调整。在 6 年的随访期间,102 名参与者(7.5%)死亡。报告 FES-I(粗略 HR 3.86,95% CI 2.37-6.29,P  < .001)或“活动受限的 FOF”与 SQ-FAR(粗略 HR 2.42,95% CI 1.44-4.09,P  = .001)均与死亡风险增加相关,但在调整性别、认知、情感和功能状态后,这些关联不再显着。结论是,虽然使用 FES-I 和 SQ-FAR 评估的高 FOF 和相关活动限制表明社区居住的年轻老年人 6 年死亡率风险增加,但在调整潜在混杂因素后,这种关联消失了。作为负面健康结果的标志,应该对 FOF 进行筛查,以便提供个性化护理并降低后续风险。

更新日期:2021-07-04
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