Participation in daily living tasks among older adults with fear of falling

Objective. This study investigated patterns of participation in daily living tasks by older adults with fear of falling. The relationship between reported participation in a broad set of daily living tasks and the risk of falling involved in task performance-or activity-related risk-as judged hy occupational therapists was examined. Further, several characteristics of older adults that have been associated with fear of falling were examined to determine which older adults had patterns of participation most strongly associated with the activity-related risk. Method. Thirty-eight occupational therapists were surveyed and asked to judge the activity-related risk in performing specific daily living tasks. Additional data were obtained from 339 older adults with fear of falling who participated in a previous study on the effectiveness of an intervention to reduce fear of falling. Older adults' participation in daily living tasks as measured by items of the Sickness Impact Profile was correlated with the judgments of activity-related risk controlling for potential confounding factors. Univariate regression analyses and t tests were used to determine whether several characteristics of older adults were associated with the relationship between participation and activity-related risk. Results. Small to moderate significant relationships were found between older adults' participation in daily living tasks and the activity-related risk as judged by occupational therapists (r = -.25, p < .0001). Older adults with the lowest confidence in ability regarding falls had the strongest relationships. Conclusion. Activity-related risk is an aspect of daily living tasks that relates to participation in activities by older adults with fear of falling. Knowledge of the activity related risk involved in daily living tasks can be used to facilitate occupational performance in clients with fear of falling and associated activity restriction.