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Falls are a common cause of injury and reduced quality of life in older adults, and they have been linked to a decline in functional independence. The ability to perform ADLs, which include essential tasks like eating, dressing, and bathing, is critical to older adults’ quality of life and autonomy. However, older adults who fear falling may limit their physical activity, leading to diminished physical capability and, ultimately, dependence on others for daily activities. This study was conducted to understand how falls efficacy—the confidence in one's ability to avoid falls—correlates with the capacity to perform ADLs.
The research was carried out in Shanghai, China, between 2018 and 2019. The sample included 336 older adults, split between those living independently at home and those attending senior day care centers. The researchers used validated scales to measure falls efficacy and ADLs: the Falls Efficacy Scale-International (FES-I) for falls efficacy and the Lawton Instrumental Activities of Daily Living (IADL) scale for ADLs. Data analysis involved statistical methods like multiple linear regression to identify the factors most closely related to falls efficacy and ADL performance.
This cross-sectional study involved 336 older adults in Shanghai, using the Falls Efficacy Scale-International (FES-I) and the Lawton Instrumental Activities of Daily Living (IADL) scale to evaluate participants' confidence in preventing falls and their daily self-care ability. Multiple regression analyses helped assess the correlation between these factors.
The study revealed a clear connection between falls efficacy and the ability of older adults to perform daily tasks without assistance. Older adults who felt more confident in their ability to prevent falls (those with higher FES-I scores) had fewer problems with ADLs, like getting dressed, bathing, and cooking. On the other hand, individuals who were more afraid of falling and had lower falls efficacy scores were more likely to struggle with these tasks and required more help.
The researchers found that even after considering other factors—like age, marital status, education level, and the use of walking aids—falls efficacy remained a strong predictor of ADL performance. This pattern held true for both groups of older adults: those living independently at home and those attending day care centers.
One interesting detail was that older adults who used day care services tended to have lower falls efficacy and more difficulty with ADLs compared to those living at home. This could be due to a combination of age, health conditions, or social factors affecting their confidence.
This study provides valuable insight into how an older adult's confidence in preventing falls can directly affect their ability to live independently. Those with higher falls efficacy are more likely to retain the ability to perform daily self-care tasks, which is critical for maintaining quality of life as people age. Improving falls efficacy through targeted interventions could be a key strategy in preventing the decline in functional ability often associated with aging. Furthermore, this study suggests that special attention should be given to older adults attending day care centers, as they may need additional support to improve their falls efficacy and maintain independence.
Wang, J., Zhao, Q., Li, Z. et al. The correlation between falls efficacy and activities of daily living among older adults receiving different types of care: a 2018–2019 cross-sectional study in Shanghai, China. BMC Public Health 23, 746 (2023). https://doi.org/10.1186/s12889-023-15605-y
By using falls efficacy as a focal point, future health interventions can aim to improve not just physical outcomes but also the psychological confidence that drives independent living.
