The effect of the interaction between fall-related self-efficacy and gait function on the occurrence of falls in community-dwelling older people

Abstract

Background: Fall-related self-efficacy and gait function are known to be associated. However, whether the interaction between fall-related self-efficacy and gait function affects future falls has not been investigated. Aim: The aim of this study was to investigate the effect of the interaction between fall-related self-efficacy and spatiotemporal gait parameters on the occurrence of falls in community-dwelling older people. Methods: A total of 265 elderly persons (age ≥ 65 years) living independently in the community were recruited. For gait function, spatiotemporal gait parameters at usual and maximum effort paces were measured using a 2.4-m walkway system with embedded pressure sensors. Furthermore, changes in gait parameters between usual and maximum paces were calculated (Δgait parameters). Fall-related self-efficacy was assessed using the short version of the Falls Efficacy Scale International (Short FES-I). The occurrence of falls was prospectively investigated 6 months later. The effect of the interaction between short FES-I and gait parameters on falls was analyzed using logistic regression analysis adjusted for confounding factors. Results: Several gait parameters were significantly different by self-efficacy level. As for the effect of the interaction of fall-related self-efficacy and gait parameters on falls, smaller Δgait parameters in those with high efficacy were associated with higher odds ratios of falls, whereas Δgait parameters in those with low efficacy were not associated with falls. Discussion and conclusions: The interaction between fall-related self-efficacy and gait function appeared to affect future falls. Assessments combining fall-related self-efficacy and gait function may improve the accuracy of prediction of future falls.