Fear of falling after hip fracture: a systematic review of measurement instruments, prevalence, interventions, and related factors

Abstract

The objective of this review was to systematically describe and analyze fear of falling (FoF) in patients after a hip fracture, focusing on measurement instruments for FoF, the prevalence of FoF, factors associated with FoF, and interventions that may reduce FoF. Fifteen relevant studies were found through a systematic literature review, in which the PubMed, Embase, PsychINFO, and CINAHL databases were searched. Some of these studies indicated that 50% or more of patients with a hip fracture suffer from FoF, although adequate instruments still have to be validated for this specific group. FoF was associated with several negative rehabilitation outcomes, such as loss of mobility, institutionalization, and mortality. FoF was also related to less time spent on exercise and an increase in falls, although knowledge about risk factors, the prevalence over a longer time period, and the exact causal relations with important health outcomes is limited. Most studies suffer from selection bias by excluding patients with physical and cognitive disorders. Hence, more research is required, including in patients who are frail and have comorbidities. Only when knowledge such as this becomes available can interventions be implemented to address FoF and improve rehabilitation outcomes after a hip fracture.