Relationship Between Fear of Falling and Outcomes of an Inpatient Geriatric Rehabilitation Population—Fear of the Fear of Falling

Authors

  • Michael D. Denkinger MD,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Wilmar Igl PhD,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Albert Lukas MD,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Anne Bader,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Stefanie Bailer,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Sebastian Franke MSc,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Claudia M. Denkinger MD, MSc,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Thorsten Nikolaus MD, PhD,

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author
  • Michael Jamour MD

    1. From the *Bethesda Geriatric Clinic and Geriatric Competence Center, Institute of Epidemiology and Geriatric Competence Center, Ulm University, Ulm, Germany; Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden; §Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Geriatric Rehabilitation Clinic, Krankenhaus GmbH Alb-Donau Kreis, Ehingen, Germany
    Search for more papers by this author

Address correspondence to Dr. med. Michael D. Denkinger, Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany. E-mail: michael.denkinger@bethesda-ulm.de

Abstract

OBJECTIVES: To examine the effects of various risk factors on three functional outcomes during rehabilitation.

SETTING: Geriatric inpatient rehabilitation unit.

DESIGN: Observational longitudinal study.

PARTICIPANTS: One hundred sixty-one geriatric rehabilitation inpatients (men, women), mean age 82, who were capable of walking at baseline.

MEASUREMENTS: Functional status was assessed weekly between admission and discharge and at a follow-up 4 months later at home using the function component of the Short Form—Late Life Function and Disability Instrument, the Barthel Index, and Habitual Gait Speed. Various risk factors, such as falls-related self-efficacy (Falls Efficacy Scale–International), were measured. Associations between predictors and functional status at discharge and follow-up were analyzed using linear regression models and bivariate plots.

RESULTS: Fear of falling predicted functioning across all outcomes except for habitual gait speed at discharge and follow-up. Visual comparison of functional trajectories between subgroups confirmed these findings, with different levels of fear of falling across time in linear plots. Thus, superior ability of this measure to discriminate between functional status at baseline across all outcomes and to discriminate between functional change especially with regard to the performance-based outcome was demonstrated.

CONCLUSION: Falls-related self-efficacy is the only parameter that significantly predicts rehabilitation outcome at discharge and follow-up across all outcomes. Therefore, it should be routinely assessed in future studies in (geriatric) rehabilitation and considered to be an important treatment goal.

Ancillary