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Current Aging Science

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ISSN (Print): 1874-6098
ISSN (Online): 1874-6128

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Research Article

Fear of Falling and Functional Mobility in Elders with Diabetic Peripheral Neuropathy in Coastal Karnataka, India: A Hospital-Based Study

Author(s): Garima Gupta, G. Arun Maiya*, Shyamasunder N. Bhat, Manjunatha H. Hande, Lisa Dillon and Lisa Keay

Volume 15, Issue 3, 2022

Published on: 29 April, 2022

Page: [252 - 258] Pages: 7

DOI: 10.2174/1874609815666220324153104

Price: $65

Abstract

Background: Aging with diabetic neuropathy is likely to predispose people to falls. Despite being a high-risk population, estimates of falls and their associated factors are poorly documented in elderly diabetic neuropathy patients living in coastal Karnataka, India.

Objective: To investigate fear of falling and functional mobility, as an approximate measure of clinical fall risk, and explore the associated risk factors in elderly diabetic neuropathy patients living in coastal Karnataka, India.

Methods: A hospital-based cross-sectional study was conducted on 316 elders aged 60 to 80 with diabetic neuropathy. A detailed diabetic foot evaluation was done. Self-reported fear of fall and functional mobility was measured using the Falls Efficacy Scale- International and Timed Up and Go test, respectively, with published cut-points. Additionally, a recall of 12 months of fall history was recorded.

Results: Descriptive analysis showed that self-reported fear of fall and below-average functional mobility was present in 39% and 49% of the elders with diabetic neuropathy, respectively. Spearman's correlational analysis revealed that self-reported fall concerns and functional mobility are significantly interdependent. Regression analysis suggested female gender, the severity of neuropathy, and previous falls as significant modifiers for fear of falls and poor functional mobility.

Conclusion: Half of the elders (49%) with diabetic neuropathy have poor functional mobility and 39% have a fear of falling. Improving physical function and addressing fall concerns of elders with diabetic neuropathy can result in greater confidence to participate in everyday activities and contribute to their better health. Hence, early fall risk identification is recommended for providing better health care to these individuals.

Keywords: Accidental fall, cross-sectional study, diabetic neuropathy, older adults, unsteadiness, prevention.

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[1]
Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol 2019; 4(1): 143-53.
[http://dx.doi.org/10.1002/lio2.252] [PMID: 30828632]
[2]
Yoshida S. A global report on falls prevention: Epidemiology of falls, ageing and life course family and community health world health organization. Geneva, Switz: World Heal Organ 2007; 1-40. Available from: http://www.who.int/ageing/projects/ 1. Epidemiology of falls in older age.pdf
[3]
Pitchai P, Dedhia HB, Bhandari N, Krishnan D, D’Souza NRJ, Bellara JM. Prevalence, risk factors, circumstances for falls and level of functional independence among geriatric population - A descriptive study. Indian J Public Health 2019; 63(1): 21-6.
[http://dx.doi.org/10.4103/ijph.IJPH_332_17] [PMID: 30880733]
[4]
International diabetes federation. IDF diabetes atlas. 8th. 2017; 1-150. Available from: https://diabetesatlas.org/resources/2017-atlas.html
[5]
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27(5): 1047-53.
[http://dx.doi.org/10.2337/diacare.27.5.1047] [PMID: 15111519]
[6]
Tracy JA, Dyck PJ. The spectrum of diabetic neuropathies. Phys Med Rehabil Clin N Am 2008; 19(1): 1-26.
[http://dx.doi.org/10.1016/j.pmr.2007.10.010] [PMID: 18194747]
[7]
Priya TMV, Rajarajeswari A, Sivakumar R. Effectiveness of training on postural stablity in mild to moderate diabetic neuropathy patients. Indian J Public Health Res Dev 2019; 10(8): 780-5.
[http://dx.doi.org/10.5958/0976-5506.2019.01985.5]
[8]
Almurdhi MM, Brown SJ, Bowling FL, et al. Altered walking strategy and increased unsteadiness in participants with impaired glucose tolerance and Type 2 diabetes relates to small-fibre neuropathy but not vitamin D deficiency. Diabet Med 2017; 34(6): 839-45.
[http://dx.doi.org/10.1111/dme.13316] [PMID: 28103405]
[9]
Hewston P, Deshpande N. Falls and balance impairments in older adults with type 2 diabetes: Thinking beyond diabetic peripheral neu-ropathy. Can J Diabetes 2016; 40(1): 6-9.
[http://dx.doi.org/10.1016/j.jcjd.2015.08.005] [PMID: 26778679]
[10]
Hewston P, Deshpande N. Fear of falling and balance confidence in older adults with type 2 diabetes mellitus: A scoping review. Can J Diabetes 2018; 42(6): 664-70.
[http://dx.doi.org/10.1016/j.jcjd.2018.02.009] [PMID: 29914779]
[11]
Tander B, Atmaca A, Ulus Y, Tura Ç, Akyol Y, Kuru Ö. Balance performance and fear of falling in older patients with diabetics: A com-parative study with non-diabetic elderly. Turk Fizik Rehabil Derg 2016; 62(4): 314-22.
[http://dx.doi.org/10.5606/tftrd.2016.77861]
[12]
Dsouza SA, Rajashekar B, Dsouza HS, Kumar KB. Falls in Indian older adults: A barrier to active ageing. Asian J Gerontol Geriatr 2014; 9(1): 33-40.
[13]
Jaafar MH, Mat S, MacKenzie L, Tan MP. Perceptions of family physicians about fall risk screening, fall risk assessment, and referral practices for fall prevention in Malaysia. Geriat Rehab 2020; 36: 38-43. Available from: https://journals.lww.com/10.1097/TGR.0000000000000252
[14]
Biçer EK. Assessment of the risk of falling in patients with diabetes. Int J Acad Med Pharm 2020; 2(2): 76-83.
[15]
Asif M, Batool S. Association between diabetic neuropathy, fall risks and balance in diabetes type 2 patients. Rawal Med J 2020; 45(1): 27-30.
[16]
Timar B, Timar R. Gaiţă L, Oancea C, Levai C, Lungeanu D. The impact of diabetic neuropathy on balance and on the risk of falls in pa-tients with type 2 diabetes mellitus: A cross-sectional study. PLoS One 2016; 11(4): e0154654.
[http://dx.doi.org/10.1371/journal.pone.0154654] [PMID: 27119372]
[17]
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLoS Med 2007; 4(10): e296.
[http://dx.doi.org/10.1371/journal.pmed.0040296] [PMID: 17941714]
[18]
Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 2005; 34(6): 614-9.
[http://dx.doi.org/10.1093/ageing/afi196] [PMID: 16267188]
[19]
Delbaere K, Close JCT, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age Ageing 2010; 39(2): 210-6.
[http://dx.doi.org/10.1093/ageing/afp225] [PMID: 20061508]
[20]
Bohannon RW. Reference values for the timed up and go test: A descriptive meta-analysis. J Geriatr Phys Ther 2006; 29(2): 64-8.
[http://dx.doi.org/10.1519/00139143-200608000-00004] [PMID: 16914068]
[21]
Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther 2000; 80(9): 896-903.
[http://dx.doi.org/10.1093/ptj/80.9.896] [PMID: 10960937]
[22]
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48(3): 452-8.
[http://dx.doi.org/10.1038/bmt.2012.244] [PMID: 23208313]
[23]
Reeves ND, Orlando G, Brown SJ. Sensory-motor mechanisms increasing falls risk in diabetic peripheral neuropathy. Medicina 2021; 57(5): 457.
[http://dx.doi.org/10.3390/medicina57050457] [PMID: 34066681]
[24]
Bokan-Mirković V, Škarić-Karanikić Ž, Nejkov S, Vuković M, Ćirović D. Diabetic polyneuropathy and risk of falls: Fear of falling and other factors. Acta Clin Croat 2017; 56(4): 721-7.
[http://dx.doi.org/10.20471/acc.2017.56.04.20] [PMID: 29590728]
[25]
Arani S, Rezaei M. DIanati M, Atoof F. The association between fear of falling and functional tests in older adults with diabetes mellitus. Nurs Midwifery Stud 2020; 9(3): 163-70.
[http://dx.doi.org/10.4103/nms.nms_86_19]
[26]
Kelly C, Fleischer A, Yalla S, et al. Fear of falling is prevalent in older adults with diabetes mellitus but is unrelated to level of neuropathy. J Am Podiatr Med Assoc 2013; 103(6): 480-8.
[http://dx.doi.org/10.7547/1030480] [PMID: 24297984]
[27]
Kukidome D, Nishikawa T, Sato M, et al. Impaired balance is related to the progression of diabetic complications in both young and older adults. J Diabetes Complications 2017; 31(8): 1275-82.
[http://dx.doi.org/10.1016/j.jdiacomp.2017.05.014] [PMID: 28610947]

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