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A theoretical and empirical review of psychological factors associated with falls-related psychological concerns in community-dwelling older people

Published online by Cambridge University Press:  30 January 2015

C. C. Hughes ,
I. I. Kneebone ,
F. Jones  and
B. Brady
C. C. Hughes
Affiliation:
Canterbury Christ Church University, Salomans Centre for Applied Psychology, UK
I. I. Kneebone*
Affiliation:
University of Western Sydney, Clinical and Health Psychology Research Initiative, Australia
F. Jones
Affiliation:
Canterbury Christ Church University, Salomans Centre for Applied Psychology, UK
B. Brady
Affiliation:
University of Western Sydney, Clinical and Health Psychology Research Initiative, Australia
*
Correspondence should be addressed to: Professor Ian Kneebone, University of Western Sydney, Locked Bag 1797, PENRITH NSW 2751, Australia. Phone: +61 2 9722 6732; Fax: +61 2 9722 6757. Email: i.kneebone@uws.edu.au.
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Abstract

Background:

Four constructs are encompassed by the term “falls-related psychological concerns” (FrPC); “fear of falling” (FOF), “falls-related self-efficacy” (FSe), “balance confidence” (BC) and “outcome expectancy” (OE). FrPC are associated with negative consequences including physical, psychological, and social. Identifying factors associated with FrPC could inform interventions to reduce these concerns.

Methods:

Sixty-two empirical papers relating to psychological factors associated with FrPC in community-dwelling older people (CDOP) were reviewed. Four levels of evidence were used when evaluating the literature: good, moderate, tentative, and none.

Results:

Evidence that anxiety predicted FOF, BC, and OE was tentative. Moderate evidence was found for anxiety predicting FSe. Good evidence was found for depression predicting FSe. Moderate evidence was found for depression predicting both FOF and BC. No evidence was found for depression predicting OE. Tentative evidence was found for FSe predicting depression. Good and moderate evidence was found for quality of life (QoL) being predicted by FOF and BC respectively. Tentative evidence was found for FSe predicting QoL. Moderate evidence was found for QoL predicting both FSe and BC. No evidence was found for QoL predicting FOF. Good and moderate evidence was found for activity avoidance/restriction (AA/AR) being predicted by FOF and FSe respectively. Tentative evidence was found for BC and OE predicting AA/AR, as well as for AA/AR predicting FOF. Moderate evidence for activity level (AL) predicting FOF was identified, however the evidence of this predicting FSe and BC was tentative. Evidence for FOF, FSe, and BC predicting AL was tentative as was evidence to suggest FOF predicted coping.

Conclusions:

Mixed evidence has been found for the association of psychological factors in association with FrPCs. Future research should employ theoretically grounded concepts, use multivariate analysis and longitudinal designs.

Keywords

fallsfear of fallingfalls self-efficacybalance confidenceoutcome expectancy
Type
Review Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 7: Late Life Anxiety , July 2015 , pp. 1071 - 1087
Copyright
Copyright © International Psychogeriatric Association 2015 

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