Are depressive symptoms, fear-avoidance beliefs, and concern about falling prognostic factors for falls in older people seeking primary health care due to a new episode of back pain?

Abstract

Background: Population aging is a global phenomenon. Back pain and falls are two factors which could potentially increase disability in older people and negatively affecting people’s lives. There are some factors known to increase odds of falls in older people, such as previous falls, age, and gender. Some psychological factors have been shown to have an association with falls, however there is still need for research. Objective: This study aimed to assess the prognostic value of depressive symptoms, fear-avoidance beliefs, and concern about falling on falls in older people with back pain. Method: 283 patients aged 55 years and over were recruited from Norwegian primary health care. They undertook a physical examination and completed a questionnaire at baseline, as well as a questionnaire at 3-, 6-, and 12-months follow-up. The outcome variable was falls registered within 12-months follow-up. Three potential modifiable prognostic factors registered at baseline were evaluated using a binary logistic regression. Depressive symptoms were measured using the Center of Epidemiological Studies Depression Scale (CES-D), fear avoidance beliefs were measured using the Fear Avoidance Beliefs Questionnaires, physical activity subscale (FABQ- PA), and concern about falling was measured using the Falls Efficacy Scale International (FES-I). Results: The study found no significant association between the three prognostic factors and falls in older people with back pain. Conclusion: Even though this study did not find an association between the factors assessed and falls, it is likely that psychological factors play a role in falls in older people. Future research should specify a sub-group of older adults due to the complexity of the group and should assess a variety of psychological factors as prognostic factors in association with falls.