Self-Awareness of Falls Risk Among Elderly Patients: Characterizing Awareness Deficits and Exploring Associated Factors

Abstract

Objective: To characterize self-awareness in older adults undergoing inpatient rehabilitation and explore factors associated with reduced awareness of falls risk.

Design: Prospective, cross-sectional design.

Setting: Older adult inpatient rehabilitation setting.

Participants: Rehabilitation inpatients (N=91; mean age, 77.97±8.04y) and their treating physiotherapist.

Interventions: None.

Main outcome measures: Three aspects of self-awareness (intellectual, emergent, anticipatory) were measured using the Self-Awareness of Falls Risk Measure. Demographic, medical, and cognitive (Mini-Mental State Examination) information were collected. Current ability was measured using the FIM and timed Up and Go test.

Results: Of the patients in the sample, 31% to 63% underestimated falls risk and 3% to 10% overestimated falls risk depending on the aspect of awareness measured. Different aspects of reduced self-awareness were correlated with being a man, higher educational attainment, neurologic history, lower cognitive ability, and lower functional ability. Regression analysis indicated that sex (β=-.33, P=.004), education (β=-.30, P=.006), and neurologic history (β=-.22, P=.038) were independently associated with overall self-awareness.

Conclusions: The results suggest that a proportion of older adults undergoing inpatient rehabilitation underestimate personal falls risk. Further research is required to investigate the contributors to and effects of reduced self-awareness of falls risk. Greater understanding of these factors will facilitate the development of strategies to increase awareness of falls risk and increase engagement in falls prevention.

Keywords: Accidental falls; Awareness; Rehabilitation.