184567 Does Alignment between Balance Confidence and Fall-Risk Predict Future Falls in Older Adults?

Monday, October 27, 2008

Richard Fortinsky, PhD , Center on Aging, University of Connecticut Health Center, Farmington, CT
Joseph Burleson, PhD , Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT
Dorothy Wakefield, MS , Center for Public Health and Health Policy, University of Connecticut Health Center, Manchester, CT
Frances Into, MA , Department of Neurology, University of Connecticut Health Center, Farmington, CT
Victoria Panzer, PhD , Department of Neurology, University of Connecticut Health Center, Farmington, CT
Objective: Low balance confidence in older adults has been used as a target for fall prevention interventions to reduce fear of falling. Less is known about how balance confidence is related to known fall-risk based on past fall history, and how this relationship may be associated with future falls. We found in previous work that 30-40% of older subjects reported higher confidence despite being at higher fall-risk, which may expose them to further falls. Accordingly, we explored how alignment between balance confidence and fall-risk is associated with prospectively reported falls. Methods: Activity-specific Balance Confidence (ABC) and fall history data were gathered from adults aged 60 or older during interviews for larger studies. Alignment was categorized as: Congruent (moderate ABC score and moderate fall-risk based on fall history), Timid (low ABC score and low fall-risk), or Overconfident (high ABC score and high fall-risk). Participants then kept daily fall logs for up to 56 weeks of follow-up. Cox survival models were evaluated using time to reported first fall as the outcome measure.

Results: There were 264 subjects (67% female; mean age = 79+6.9 years). Most (68%) were Congruent, 28% were Overconfident, and 3% were Timid. Congruent subjects experienced their first fall significantly sooner than Overconfident subjects (Wald = 6.12, p = .013); no other contrasts were different. Conclusion: Subjects reporting higher balance confidence despite higher fall-risk experienced delays in subsequent falls compared to others. This finding suggests that increasing confidence in older adults with known higher fall-risk may delay future falls.

Learning Objectives:
1. Explain fall prevention approaches for older adults 2. Understand how balnce confidence is measured in older adults. 3. Discuss how balance confidence and known fall risk interact to influence future falls.

Keywords: Aging, Injury Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I led the team that conducted this research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.