ABSTRACT

1. Fear of Falling and Activity Restriction among Community-Dwelling Older Adults PO 6025 Jane A. Painter, EdD, OTR/L, FAOTA & Leonard G. Trujillo, PhD., OTR/L, FAOTA Department of Occupational Therapy East Carolina University College of Allied Health Sciences Greenville, North Carolina 27858 252.744.6199 painterj@ecu.edu trujillol@ecu.edu ABSTRACT RESULTS DISCUSSION • Findings from the current research offer new insights regarding the interrelationship between FOF & activity level, FOF & depression, and FOF & anxiety. Current results suggest the importance of addressing anxiety and depression in relation to FOF and activity level. A strength of the current research relates to using the SAFE assessment since it does not require estimation activity performance a person does not do . Our findings, coupled with those of past research suggest that older adults who were more actively engaged in ADLs and IADLS had a lower FOF, less depression, and lower anxiety. Conversely, participants who were more fearful, depressed, and anxious restricted their activity level.  In summary, OT practice implications include the following considerations: • A person can develop a FOF whether or not a fall has occurred. • Anxiety has been found to cause a fear of falling. • Fear of falling can lead to increased fall risk, decreased motivation, and decreased perceptions of capabilities, all of which can then lead to self-imposed activity restriction. • Occupational therapy practitioners should assess for FOF and anxiety for older adults who display anxiety and decreased motivation to perform functional activities. This study examined the relationship of fear of falling (FOF) to depression, anxiety, activity level, and activity restriction & whether depression or anxiety predicted FOF, activity level, activity restriction, or changes in activity level. Significant relationships were found between FOF & depression, anxiety, & activity level; depression & anxiety; and activity restriction & depression. Activity level was negatively correlated with activity restriction, FOF, depression, & anxiety. Anxiety predicted both FOF & activity level. Both anxiety & depression predicted activity restriction because of fear of falling and for other reasons. OT practitioners should consider screening older adult clientele for FOF, anxiety, & depression since they may lead to fall risk and activity restriction.1 Significant Relationship Between FOF, Depression, & Anxiety Participant Demographics INTRODUCTION A fall is an unintentional, sudden change in body position resulting in contact with the ground in the absence of an external force or intrinsic event.2 FOF, a concomitant psychological symptom, is an constant worry about falling; it is increasingly identified among community-dwelling older adults who have and have not fallen.3 FOF can lead to increased fall risk, decreased quality of life, & activity restriction (20-60%).3 Older adults who have FOF have the highest level of depression (37.5%). Little research has been done to explore relationship between FOF and anxiety. FOF creates a vicious downward spiral of physical and occupational performance and activity restriction. This study examined the relationship between FOF with anxiety, depression, and activity engagement among community-dwelling older adults.1 REFERENCES 1Painter, J. A., Allison, L., Dhingra, P., Daughtery, J., Cogdill, K., & Trujillo, L. G. (2012). Fear of falling and its relationship with anxiety, depression, and activity engagement among community-dwelling older adults. AJOT, 66, 169–176. 2World Health Organization. (2010). Falls: Fact sheet No. 344. Retrieved November 15, 2010 from www.who.int/media centre/factsheets/fs344/en/index.html 3Boyd, R., & Stevens, J. A. (2009). Falls and fear of falling: Burden, beliefs and behaviours. Age and Ageing, 38, 423–428. 4Lachman, E., Howland, J., Tennstedt, S., Jette, A., Assmann, S., & Peterson, E. (1998). Fear of falling and activity restriction: The Survey of Activities and Fear of Falling in the Elderly (SAFE). J of Gerona, Series B: 53B, 43–50. 5Yesavage, J. A., Brink, J. A., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49. 6Hamilton, A. (1969). Diagnosis and rating of anxiety. British Journal of Psychiatry Special Publication, 3, 76–79. METHODS & INSTRUMENTATION The Survey of Activities and FOF in the Elderly4; the Geriatric Depression Scale–305; & the Hamilton Anxiety Scale, IVR6 during a one-time, two hour appointment with 99 community-dwelling adults ≥ 55 yr old from 7 community centers and 1 apartment complex in eastern rural North Carolina.