Journal of the American Medical Directors Association
Review ArticleFear of Falling and Gait Variability in Older Adults: A Systematic Review and Meta-Analysis
Section snippets
Literature Search
A systematic Medline literature search was conducted in May 2014 without restriction of date and language, using the Medical Subject Heading (MeSH) terms “Fear” OR “fear of falling” combined with “Accidental Falls” AND “Gait” OR “Gait Apraxia” OR “Gait Ataxia” OR “Gait disorders, Neurologic” OR “Gait assessment” OR “Functional gait assessment” AND “Self efficacy” OR “Self confidence” AND “Aged” OR “Aged, 80 and over.” An iterative process was used to ensure all relevant articles had been
Results
All studies were judged of good quality using the Newcastle-Ottawa Scale (see Appendix 2). Supplementary Table 1 summarizes the 10 studies included in this review and meta-analysis.6, 10, 21, 22, 23, 24, 25, 26, 27, 28 Data collection was based on cross-sectional design for 5 studies,8, 21, 22, 27, 28 on prospective observational cohort design for 4 studies,23, 24, 25, 26 and on case-control design for 1 study.6 Population ranged from 5224 to 1307,26 and was most frequently female with a
Discussion
This systematic review and meta-analysis shows that FOF is associated with a small, significant increase in gait variability (ie, worst performance of gait). In addition, mixed results of qualitative analysis suggest that this association may be influenced by other covariables that should be taken into account when examining it.
Four studies of the 10 selected have shown a significant FOF-related increase in gait variability.6, 25, 27, 28 In these studies, FOF was assessed either by the ABC
Acknowledgments
We thank Melinda Beaudenon, MS, Jennifer Gautier, BS, Simon Romain, MS, and Anastasiia Kabeshova, MS, from Angers University Memory Clinic, France, for daily assistance. There was no compensation for this contribution. We are also grateful to Jeffrey Hausdorff, Orna Donoghue, and Ryuichi Sawa for their cooperation, and more precisely for providing supplementary data from their published study that was required to perform a meta-analysis.
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C.A. has served as an unpaid consultant for Ipsen Pharma Company, and serves as an associate editor for Gériatrie, Psychologie et Neuropsychiatrie du Vieillissement, and for the Journal of Alzheimer's Disease. He has no relevant financial interest in this manuscript. O.B. has served as an unpaid consultant for Ipsen Pharma Company, and serves as an associate editor for Gériatrie, Psychologie et Neuropsychiatrie du Vieillissement. He has no relevant financial interest in this manuscript.
This study was funded by Biomathics. The sponsors had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.
The authors declare no conflicts of interest.