Abstract
Introduction: Fear of falling is a common psychological consequence following falls and fragility fractures, contributing to functional decline, reduced quality of life, and increased risk of further falls and fractures. The Fracture Liaison Service (FLS) routinely assesses fall risk to prevent secondary fractures. This study evaluates the quality of falls assessment with respect to psychological impact like fear of falling. In addition, we assessed an association of fear of falling with single or recurrent falls among patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS).
Methods: A retrospective cohort analysis was conducted on 2,176 patients reviewed by AB-FLS between January and December 2023. Falls risk assessment was documented in 81.3% (n=1768 patients). Complete data on both falls frequency and fear of falling was only available in 50.2% (n=1093 patients), which is a limitation of this study. Data were stratified into recurrent falls (≥2 falls) and single fall groups.
Results: The mean age was 79.4±9.6 years (range = 50-100). Women were 76.9% (n=1675) and men were 23.1% (n=501). Only 5.5% (n=60) patients were admitted from care homes. Single and recurrent falls occurred in 59.7% and 40.3% of patients respectively. The mean age (SD, range) for patents with single falls and recurrent falls were 79.1±9.5 (50-100) and 79.8±9.7 (53-100) respectively.
Fear of falling was reported by 40.2% (n=365). Majority of patients (89.6%, n=327) who reported fear of falling have recurrent falls and in comparison, only 10.4% (n=38) patients with a single fall reported fear of falling, the difference being statistically significant (p<0.001).
Conclusion: This study demonstrates fear of falling was not assessed in nearly half of the patients with fragility fractures. This study has also shown a strong association between recurrent falls and fear of falling. Patients experiencing recurrent falls were 8.6 times more likely to report fear of falling compared to single only fallers. Tailored interventions addressing both physical and psychological factors need to incorporated in the falls assessment for patients seen through FLS.
Comments
A very important topic,…
Thanks
We have introduced Education programme for patients, EPP Cymru (WG funded this) Happy to share feedback and interventions
An interesting piece of work...
Fear of falling and confidence is such an important issue. Is fear of falling specifically built into the assessments? I too am interested in what the tailored intervention might look like
This is a very relevant and…
This is a very relevant and insightful topic. The fear of falling is not only a psychological consequence of previous falls but also an important independent risk factor for both single and recurrent falls. It often leads to reduced mobility, muscle deconditioning, and loss of confidence, which further increase fall risk—a classic vicious cycle. Exploring this association is crucial for developing comprehensive fall prevention programs that address both physical and psychological components of fall risk.
Good Work. All the best 💯
Thanks
please do share if you have further feedback
This is very relevant topic
This is a very relevant and insightful topic. . This research effectively draws attention to a growing public health concern and the need for improved screening and preventive strategies.It often leads to reduced mobility, muscle deconditioning, and loss of confidence, which further increase fall risk—a classic vicious cycle.
Good Work. All the best 💯
Interesting intervention
It's interesting how physical and psychological factor for recurrent falls is interlinked. The study is thoughtful and well done.
This is a really interesting…
This is a really interesting and important aspect of falls management. I also wondered how fear of falling was assessed, and whether the social component of falls (e.g. social isolation, reduced social contact) is also addressed during this process?