Resiliência e medo de cair em idosos comunitários de diferentes contextos socioeconômicos e culturais - um estudo transversal

Abstract

Introduction: The fear of falling is a real or unreal sensation of a fall and a common consequence after falling episodes. It can create a vicious cycle in older individuals through a persistent emotional response that indirectly influences functionality and quality of life. Resilience, on the other hand, is the ability to positively adapt after adverse situations. In older people, it is an adaptive and assertive psychological response that can mitigate the fear of falling by adapting positively to situations like falls. Resilience is modulated by various sociocultural factors, implying a complex assessment of life experiences and the current conditions of the lifestyle of aging populations. Objectives: To analyze if resilience levels are associated with the fear of falling in a sample of older individuals with different socioeconomic and cultural profiles. Methodology: This is a subset of the International Mobility and Aging Study (IMIAS) with data from 2016. Resilience levels were measured using the 14-item Resilience Scale (RS-14), and the fear of falling was assessed using the Fall Efficacy Scale-International (FES-I). Multiple linear regression models were used to analyze the association between outcome and exposure variables, controlled for sociodemographic covariates (age, study location, gender, educational level, income sufficiency, and marital status) and clinical conditions (depressive symptoms, visual impairment, physical performance, and falls in the last year). Results: The sample comprised 1,506 older individuals. Resilience levels were lower in Tirana, negatively correlated with the fear of falling in all locations. The regression analysis indicated an independent association between resilience levels and the fear of falling (β = -0.116; CI = -0.157/-0.076; p < 0.001). Conclusion: This study reveals that older individuals with higher resilience levels exhibit less fear of falling, emphasizing the importance of a biopsychosocial approach in physiotherapy. The correlation between the fear of falling and socioeconomic conditions underscores the need for public policies to improve infrastructure, promoting an environment conducive to resilience and contributing to healthy aging.