Gender perspective on fear of falling using the classification of functioning as the model

Abstract

Purpose: To investigate associations between fear of falling (FOF) and recurrent falls among women and men, and gender differences in FOF with respect to International Classification of Functioning (ICF). Methods: Community-dwelling people (n = 230, 75–93 years, 72% women) were included and followed 1 year regarding falls. Data collection included self-reported demographics, questionnaires, and physical performance-based tests. FOF was assessed with the question “Are you afraid of falling?”. Results were discussed with a gender relational approach. Results: At baseline 55% women (n = 92) and 22% men (n = 14) reported FOF. During the follow-up 21% women (n = 35) and 30% men (n = 19) experienced recurrent falls. There was an association between gender and FOF (p = 0.001), but not between FOF and recurrent falls (p = 0.79), or between gender and recurrent falls (p = 0.32). FOF was related to Personal factors and Activity and Participation. The relationship between FOF and Personal factors was in opposite directions for women and men. Conclusions: Results did not support the prevailing paradigm that FOF increases rate of recurrent falls in community-dwelling people, and indicated that the answer to “Are you afraid of falling?” might be highly influenced by gendered patterns.

Implications for Rehabilitation

• The question “Are you afraid of falling?” has no predictive value when screening for the risk of falling in independent community-dwelling women or men over 75 years of age.

• Gendered patterns might influence the answer to the question “Are you afraid of falling?” Healthcare personnel are recommended to be aware of this when asking older women and men about fear of falling.

• Falls
• fear
• gender
• ICF
• older people

Acknowledgements

We would like to thank all the participants and colleagues that helped with baseline assessments.

Author contributions

All authors participated in conceiving and designing the study, interpreting data, and drafting the manuscript. E.N. and L.L.O. acquired the participants and the data. P.P., A.L., and L.L.O. performed the statistical analyses. E.N., C.A., A.L., and L.L.O. critically revised the manuscript. All authors read and approved the final manuscript.

Declaration of interest

The authors report no conflict of interest. Financial support was granted by the Swedish Research Council (521-2003-5538 and additional grant 5221-2011-3250).