Factors Associated with Fall-Efficacy in Older Adults with Chronic Obstructive Pulmonary Disease
Keywords:
Chronic obstructive pulmonary disease, Older adults, Fall-efficacy, Depression, BalanceAbstract
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality. It further leads to impair balance, due to systemic inflammation and muscle strength decreasing. Meta-analytic evidence indicates that approximately 30% of individuals with stable COPD experience falls, Objective: This descriptive correlational study examined fall-efficacy and its associated factors in older adults with chronic obstructive pulmonary disease (COPD). Methods: The 126 participants who met the eligibility criteria were recruited using a simple random sampling technique from the respiratory medicine outpatient clinic of a university hospital in China between December 2024 and January 2025. Data were collected using validated Chinese-language instruments, including the Modified Falls Efficacy Scale, the Geriatric Depression Scale-15, the Activities of Daily Living scale, the Self-Rated General Health measure, the COPD Assessment test, and the Timed Up and Go test. Data were analyzed using descriptive statistics and Spearman’s rho correlation. Results: The mean age of the participants was 70.19 years (SD=6.09). Fall-efficacy was high (mean = 8.59, SD = 1.52). Fall-efficacy was strongly negatively correlated with depression, poorer balance ability, and COPD-related health impact (ρ=-0.641, ρ=-0.543, and ρ=-0.508, respectively; all p < .001). It was moderately negatively correlated with perceived health status and number of medications used (ρ = -0.444 and ρ = -0.326, respectively; both p < .001). Age showed a weak negative correlation (ρ = -0.259, p = .003), whereas ADL showed a weak positive correlation with fall-efficacy (ρ = 0.182, p = .041). No significant association was found between fall history and fall-efficacy (ρ = -0.147, p = .099). Conclusion: In conclusion, fall-efficacy in older adults with COPD is associated with multidimensional factors across ICF domains. These factors should be incorporated into routine assessment and daily management to facilitate early identification and monitoring.
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