Assessing patients with fear of falling. Does the method use change the results? A systematic review

Objective: To analyse if the use of different methods to assess fear of failing (FF), changes the risk factors for developing it, and the consequences arising from this. Design: Systematic review. Data sources: Electronic data bases, MEDLINE, EMBZ, EMBASE, CINAHL and PBMA. Key words "fear, fait and aged+65 years", "fear of falling", "post-fall syndrome", "self-efficacy, fall and aged+65 years". Period: 1966-March 2008. Selecting the studies: Inclusion/exclusion criteria: original observational studies, clearly identifying the method employed to measure FF and which mention risk factors and/or the consequences arising from this fear. A total of 327 summaries were initially identified, from which 24 articles were selected. Data collection: The abstracts and articles were selected by the first author. If there were doubts, the opinion of the second signatory was considered. The method for detecting FF, the risk factors and/or the consequences were collected and analysed. Results: There is a large variety of FF assessment methods, which can be grouped into three types: a) they question directly if it exists; b) they question on the limitation of activity due to this fear, and c) they use scales that detect and quantify the fear. The main risk factors: changes in gait, previous falls, failing sight, health problems, female sex and tack of social support. Main consequences: balance problems, depression, increased risk of falls and less social activity. Conclusions: The risk factors and consequences of FF are similar in the different studies, particularly those that employ direct questions. The study population, the objective and the time available have an effect on the choice of method for assessing FF. (c) 2008 Elsevier Espana, S.L. All rights reserved.