Is Fear of Falling the Missing Link to Explain Racial Disparities in Fall Risk? Data from the National Health and Aging Trends Study

Clin Gerontol. 2020 Jul-Sep;43(4):465-470. doi: 10.1080/07317115.2018.1468377. Epub 2018 May 15.

Abstract

Objectives: Emerging research suggests Black older adults experience a 30% decreased risk for falls compared with their White U.S. counterparts, and this is mediated neither by physical performance nor activity. Fear of falling (FOF) is a significant risk factor for falls, yet we know little about how FOF varies by race/ethnicity. The purpose of this original research brief was to investigate the relationship between race/ethnicity and FOF among older adults.

Methods: 4,981 community-dwelling Medicare beneficiaries from the National Health and Aging Trends Study (NHATS) who had not self-reported a fall in the past 12 months were analyzed. Logistic regression analyses were conducted to examine the association between race/ethnicity and fear of falling, controlling for sex, age, total annual income, and mobility assistance.

Results: FOF differed significantly across racial groups. Black, non-Hispanic older adults were less likely to have FOF (OR = .87, 95% CI = .71,1.07) compared with their White, non-Hispanic counterparts. In the fully adjusted model, this difference persisted and became stronger (adjusted OR = .75, 95%CI = .61, .93).

Conclusion: The decreased risk for falls in Black older adults could be explained by lower FOF in this group.

Clinical implications: These findings should inform public health fall prevention initiatives among community-dwelling older adults.

Keywords: Fear of falling; Medicare beneficiaries; health disparities; older adults; race; risk factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Accidental Falls* / prevention & control
  • Aged
  • Aging
  • Fear*
  • Female
  • Humans
  • Independent Living
  • Male
  • Medicare*
  • United States