111 Disparities between Actual and Perceived Fall Risk Affect Participation in 5 Fall Prevention Interventions

• Published in: Age and ageing Vol. 48; no. Supplement_4; pp. iv18 - iv27
• Main Authors: Tan, Pey June, Sim, Silvia, Ismail, Noor Hafizah, Mallya, Jagadish, Chan, Angelique, Wong, Chek Hooi
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 20-12-2019; Oxford Publishing Limited (England)
• Subjects: Anxiety disorders; Behavior; Drugs; Efficacy; Falls; Fear; Fear & phobias; Frail; Health care; Health risks; Help seeking behavior; Injury prevention; Intervention; Medical personnel; Older people; Participation; Prevention; Prevention programs; Random sampling; Risk perception; Statistical sampling; Uptake; Singapore; Intervention; Participation; Perception; Behaviour; Fear-of-falling
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afz164.111

Abstract
Introduction
Older adults have been found to under- or overestimate their fall risk. However, no studies have investigated implications on help-seeking behaviours in falls prevention. This study examines how disparities between actual and perceived fall risk affects participation in 5 fall prevention interventions among community-dwelling older adults in Singapore.
Methods
This was a cross-sectional survey of a nationally representative sample of community-dwelling adults aged ≥60 years in Singapore identified by stratified random sampling. Having previous falls in the past 12 months (faller/non-faller) indicated actual fall risk. Level of fear-of-falling (cut-off ≥23 on 16-item Falls Efficacy Scale International) was used as perceived fall risk (high/low). Four profiles based on combinations of actual and perceived risk were associated with participation in 5 fall prevention interventions in a multiple logistic regression. The model was adjusted for age, gender, ≥2 comorbidities and knowledge that the intervention is to prevent falls.
Results
Final analysis included 549 older adults (mean age 70.6±6.9 years, 61% females). Majority (46%) were in the Vigorous group (no falls, low fear), 35% Anxious (no falls, high fear), 11% Frail Aware (falls, high fear) and 8% Stoics (falls, low fear). Only those in Anxious and Frail Aware group were significantly more likely to have talked to a healthcare professional on strategies to avoid falls [OR 1.8 (1.1-3.1) and 3.2 (1.6-6.4) respectively] and made home modifications [OR 1.9 (1.3-2.8) and 2.0 (1.1-3.6)] after adjustments. No association was found for participation in exercise, medication review and falls education.
Discussion
Individual profiles with high fear-of-falling component have different help-seeking behaviours compared to those with low fear regardless of history of falls. However, individuals in Frail Aware group have higher likelihood to uptake the interventions compared to Anxious group. Future research should examine other drivers of behaviour that will influence participation in other interventions.