A longitudinal study of disability in activities of daily living and activity restriction-induced fear of falling among Korean older people.
Seong Sook Jun, Eunyoung Lee
PMID 36480315WHAT IT FOUND
Older adults who limited activities because they feared falling had more disability in daily tasks over 10 years.
Fear of falling without limiting activities was not linked to disability.
Key findings
01Activity restriction due to fear of falling was linked to ADL and IADL disability over the study period, while fear of falling alone was not.
02In the activity-restriction group, the percentage with disability in more than one daily task rose from 5.81% in 2008 to 11.80% in 2018, and the percentage with disability in more than one community task rose from 17.79% to 23.77%.
03ADL disability was linked to impaired cognitive function regardless of activity restriction, and other links differed between participants with and without activity restriction.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The data were self-reported and collected every 2 years, so response and recall bias are possible. Panel attrition was high: dropout increased from 10.6% in 2010 to 31.8% in 2018, and the authors say results may not represent older people with poor health. Important frailty-related factors, such as weight loss, exhaustion, gait speed and balance, were not analysed. The study is observational, so it cannot show that activity restriction caused disability. The baseline incidence of disability was low (0.85% for ADL and 6.6% for IADL in the analysed second wave), so the sample was relatively healthy.
Declared interests
The authors reported no conflicts of interest and no specific funding for this analysis. Ethical approval was waived because the analysis used deidentified secondary data.
The easy way to misread this
Do not conclude that fear of falling itself predicts loss of daily independence. Fear without activity restriction was not linked to ADL or IADL disability; only limiting activities because of fear was linked.