Skip to main content

Advertisement

SpringerLink
Log in

Factors associated with fear of falling in hemodialysis patients

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

Fear of falling (FOF) has important clinical and psychological consequences. This study evaluated the factors associated with FOF in hemodialysis patients and compared with the FOF reported by age–gender matched individuals without chronic kidney disease.

Methods

This cross sectional study included hemodialysis group (n = 60, 55.4 ± 7.6 years, 55.0% male) and control group (n = 40, 55.1 ± 7.5 years, 52.5% male). FOF was assessed by the Falls Efficacy Scale International (FES-I). Physical function was evaluated using the Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go test, 4-m gait speed, isometric handgrip force and 10-repetition sit-to-stand test. The physical and mental components of quality of life was evaluated by 36-Item Short Form Health Survey.

Results

The FES-I score was higher in the hemodialysis group compared to the control group (28.2 ± 9.7 vs. 23.3 ± 5.1, p = 0.020). In addition, the prevalence of individuals with a higher concern about falling was greater in the hemodialysis group (41.7 vs. 17.5%, p = 0.033). Multiple linear regression showed that the FES-I score was associated with the Mini-BESTest score and the physical component summary of quality of life (coefficient of determination of 0.51 and an adjusted coefficient of determination of 0.46).

Conclusion

FOF was associated with poor postural balance and reduced physical component of quality of life in patients on hemodialysis and these patients showed higher FOF compared to individuals without chronic kidney disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Abdel-Rahman EM, Turgut F, Turkmen K, Balogun RA (2011) Falls in elderly hemodialysis patients. QJM 104:829–838. https://doi.org/10.1093/qjmed/hcr108

    Article  CAS  PubMed  Google Scholar 

  2. López-Soto PJ, De Giorgi A, Senno E, Tiseo R, Ferraresi A, Canella C, Rodríguez-Borrego MA, Manfredini R, Fabbian F (2015) Renal disease and accidental falls: a review of published evidence. BMC Nephrol 16:176. https://doi.org/10.1186/s12882-015-0173-7

    Article  PubMed  PubMed Central  Google Scholar 

  3. Van Loon IN, Joosten H, Iyasere O, Johansson L, Hamaker ME, Brown EA (2019) The prevalence and impact of falls in elderly dialysis patients: Frail elderly Patient Outcomes on Dialysis (FEPOD) study. Arch Gerontol Geriatr 83:285–291. https://doi.org/10.1016/j.archger.2019.05.015

    Article  PubMed  Google Scholar 

  4. Tinetti ME, Richman D, Powell L (1990) Falls efficacy as a measure of fear of falling. J Gerontol 45:239–243. https://doi.org/10.1093/geronj/45.6.p239

    Article  Google Scholar 

  5. Delbaere K, Close JC, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR (2010) The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age Ageing 39:210–216. https://doi.org/10.1093/ageing/afp225

    Article  PubMed  Google Scholar 

  6. Scheffer AC, Schuurmans MJ, Van Dijk N, Van der Hooft T, De Rooij SE (2008) Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 37:19–24. https://doi.org/10.1093/ageing/afm169

    Article  PubMed  Google Scholar 

  7. Schoene D, Heller C, Aung YN, Sieber CC, Kemmler W, Freiberger E (2019) A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls? Clin Interv Aging 14:701–719. https://doi.org/10.2147/CIA.S197857

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hadjistavropoulos T, Delbaere K, Fitzgerald TD (2011) Reconceptualizing the role of fear of falling and balance confidence in fall risk. J Aging Health 23:3–23. https://doi.org/10.1177/0898264310378039

    Article  PubMed  Google Scholar 

  9. Oliveira CC, McGinley J, Lee AL, Irving LB, Denehy L (2015) Fear of falling in people with chronic obstructive pulmonary disease. Respir Med 109:483–489. https://doi.org/10.1016/j.rmed.2015.02.00

    Article  PubMed  Google Scholar 

  10. Gazibara T, Kurtagic I, Kisic-Tepavcevic D, Nurkovic S, Kovacevic N, Gazibara T, Pekmezovic T (2017) Falls, risk factors and fear of falling among persons older than 65 years of age. Psychogeriatrics 17:215–223. https://doi.org/10.1111/psyg.12217

    Article  PubMed  Google Scholar 

  11. Khalil H, Al-Shorman A, El-Salem K, Abdo N, Alghwiri AA, Aburub A, Shalabi S, Al-Mustafa F (2017) Fear of falling in people with multiple sclerosis: which clinical characteristics are important? Phys Ther 97:698–706. https://doi.org/10.1093/ptj/pzx044

    Article  PubMed  Google Scholar 

  12. Bokan-Mirković V, Škarić-Karanikić Ž, Nejkov S, Vuković M, Ćirović D (2017) Diabetic polyneuropathy and risk of falls: fear of falling and other factors. Acta Clin Croat 56:721–727.https://doi.org/10.20471/acc.2017.56.04.20

  13. Liu TW, Ng GYF, Chung RCK, Ng SSM (2018) Decreasing fear of falling in chronic stroke survivors through cognitive behavior therapy and task-oriented training. Stroke 50:148–154. https://doi.org/10.1161/STROKEAHA.118.022406

    Article  Google Scholar 

  14. Wolfgram DF, Lathara Z, Szabo A, Whittle J (2017) Dialytic hemodynamics are associated with changes in gait speed. Hemodial Int 21:566–574. https://doi.org/10.1111/hdi.12515

    Article  PubMed  Google Scholar 

  15. Galvão MH, Santos LIS, Barcelar JM, Marinho PEM (2013) Assessment of the capacity of the Falls Efficacy Scale International in specifying the risk of falling in patients with chronic kidney disease on hemodialysis. Fisioter Pesq 20:151–157. https://doi.org/10.1590/S1809-29502013000200009

    Article  Google Scholar 

  16. Lamb SE, Jørstad-Stein EC, Hauer K, Becker C, Prevention of Falls Network Europe and Outcomes Consensus Group (2005) Development of a common outcome data set for fall injury prevention trials: the prevention of falls network Europe consensus. J Am Geriatr Soc 53:1618–1622. https://doi.org/10.1111/j.1532-5415.2005.53455.x

    Article  PubMed  Google Scholar 

  17. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Toddet C (2005) Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 34:614–619. https://doi.org/10.1093/ageing/afi196

    Article  PubMed  Google Scholar 

  18. Portney LG, Watkins MP (2009) Foundations of clinical research: applications to practice. Pearson Prentice Hall, New Jersey, p 93

    Google Scholar 

  19. Hoang OT, Jullamate P, Piphatvanitcha N, Rosenberg E (2017) Factors related to fear of falling among community-dwelling older adults. J Clin Nurs 26:68–76. https://doi.org/10.1111/jocn.13337

    Article  PubMed  Google Scholar 

  20. Denkinger MD, Lukas A, Nikolaus T, Hauer K (2015) Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review. Am J Geriatr Psychiatry 23:72–86. https://doi.org/10.1016/j.jagp.2014.03.002

    Article  PubMed  Google Scholar 

  21. Garcia PA, Dias JMD, Silva SLA, Dias RC (2015) Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement. Braz J Phys Ther 19:218–226. https://doi.org/10.1590/bjpt-rbf.2014.0095

    Article  PubMed  PubMed Central  Google Scholar 

  22. Segura-Ortí E, Gordon PL, Doyle JW, Johansen KL (2018) Correlates of physical functioning and performance across the spectrum of kidney function. Clin Nurs Res 27:579–596. https://doi.org/10.1177/1054773816689282

    Article  PubMed  Google Scholar 

  23. Erdoğanoğlu Y, Yalçin B, Külah E, Kaya D (2019) Is there a relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients? Hemodial Int 23:273–278. https://doi.org/10.1111/hdi.12724

    Article  PubMed  Google Scholar 

  24. Zanotto T, Mercer TH, van der Linden ML, Traynor JP, Doyle A, Chalmers K, Allan N, Shilliday I, Koufaki P (2020) Association of postural balance and falls in adult patients receiving haemodialysis: a prospective cohort study. Gait Posture 82:110–117. https://doi.org/10.1016/j.gaitpost.2020.08.128

    Article  PubMed  Google Scholar 

  25. Zanotto T, Mercer TH, van der Linden ML, Traynor PCJ, Doyle A, Chalmers K, Allan N, Price J, Oun H, Shilliday I, Koufaki P (2018) Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients. PLoS ONE 13:e0208127. https://doi.org/10.1371/journal.pone.0208127

    Article  PubMed  PubMed Central  Google Scholar 

  26. Shin S, Chung HR, Fitschen PJ, Kistler BM, Park HW, Wilund KR, Sosnoff JJ (2014) Postural control in hemodialysis patients. Gait Posture 39:723–727. https://doi.org/10.1016/j.gaitpost.2013.10.006

    Article  PubMed  Google Scholar 

  27. Erken E, Ozelsancak R, Sahin S, Yılmaz EE, Torun D, Leblebici B, Kuyucu YE, Sezer S (2016) The effect of hemodialysis on balance measurements and risk of fall. Int Urol Nephrol 48:1705–1711. https://doi.org/10.1007/s11255-016-1388-7

    Article  CAS  PubMed  Google Scholar 

  28. Di Carlo S, Bravini E, Vercelli S, Massazza G, Ferriero G (2016) The Mini-BESTest: a review of psychometric properties. Int J Rehabil Res 39:97–105. https://doi.org/10.1097/MRR.0000000000000153

    Article  PubMed  Google Scholar 

  29. Frih B, Mkacher W, Jaafar H, Frih A, Salah ZB, May EM, Hammami M (2018) Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis. Disabil Rehabil 40:784–790. https://doi.org/10.1080/09638288.2016.1276971

    Article  PubMed  Google Scholar 

  30. Lach HW, Parsons JL (2013) Impact of fear of falling in long term care: an integrative review. J Am Med Dir Assoc 14:573–577. https://doi.org/10.1016/j.jamda.2013.02.019

    Article  PubMed  Google Scholar 

  31. Neves PDMM, Sesso RCC, Thomé FS, Lugon JR, Nasicmento MM (2020) Brazilian Dialysis Census: analysis of data from the 2009–2018 decade. Braz J Nephrol 42:191–200. https://doi.org/10.1590/2175-8239-jbn-2019-0234

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank the nursing and medical staff at the Nephrology Units for their friendly support.

Funding

This study was supported by a Research Grant from Fundação de Amparo à Pesquisa do Estado de Minas Gerais—FAPEMIG; and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

Author information

Authors and Affiliations

  1. Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil

    Luciana Angélica da Silva de Jesus, Bruno Valle Pinheiro, Leda Marília Fonseca Lucinda, Emanuele Poliana Lawall Gravina, Fabrício Sciammarella Barros, Rodrigo Schinniger Assun Garcia & Maycon Moura Reboredo

  2. School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil

    Bruno Valle Pinheiro & Maycon Moura Reboredo

  3. Centre of Health, Activity and Rehabilitation Research, School of Health Sciences, Queen Margaret University, Scotland, UK

    Pelagia Koufaki

  4. Department of Morphology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil

    Leda Marília Fonseca Lucinda

  5. Department of Physiotherapy, Federal University of Juiz de Fora - Governador Valadares, Governador Valadares, Minas Gerais, Brazil

    Cristino Carneiro Oliveira

  6. Av. Eugênio do Nascimento s/nº - Dom Bosco, Juiz de Fora, Minas Gerais, 36038-330, Brazil

    Maycon Moura Reboredo

Authors
  1. Luciana Angélica da Silva de Jesus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bruno Valle Pinheiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pelagia Koufaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Leda Marília Fonseca Lucinda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Emanuele Poliana Lawall Gravina
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fabrício Sciammarella Barros
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rodrigo Schinniger Assun Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cristino Carneiro Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Maycon Moura Reboredo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maycon Moura Reboredo.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

Approval of the institutional review board of the University Hospital of the Federal University of Juiz de Fora Research Ethics Committee (N° 2.458.176/ 2017).

Informed consent

All patients whose data were analyzed were informed of the use of their information under anonymization and received an opportunity to object to use or publication.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

da Silva de Jesus, L.A., Pinheiro, B.V., Koufaki, P. et al. Factors associated with fear of falling in hemodialysis patients. Int Urol Nephrol 53, 2159–2166 (2021). https://doi.org/10.1007/s11255-021-02856-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-021-02856-0

Keywords

Search

Navigation