This study examined heterogeneity in response patterns of the participants of the Survey of Activities and Fear of Falling in the Elderly (SAFFE) and their relationships to falls, functional ability, quality of life, and activity restriction measures in a cohort of 256 older people (mean age ¼ 77.5 years). Participants recruited from local primary care clinics were administered the SAFFE instrument, an activity restriction measure, a combination of self-reported and performance-based functional ability tests, and quality-of-life measures. Latent class analyses identified two classes: Class 1 (n ¼ 209), which had a low SAFFE fear of falling, and Class 2 (n ¼ 47), which had a high SAFFE fear of falling. Subsequent analyses of variance indicated that the two-class (low fear and high fear) SAFFE fear of falling profiles discriminated fallers from nonfallers, and low and high levels of functional ability, activity restriction, and quality of life. The findings from this study suggest that variations in the SAFFE response patterns on a single dimension of fear of falling and that high levels of fear of falling measured by the SAFFE are linked to a range of adverse health consequences.
FALLS are among the most common and serious health problems facing elderly persons (American Geriatrics Society [AGS], British Geriatrics Society, & American Academy of Orthopedic Surgeons, 2001; Howland, Peterson, & Lachman, 2001; Sattin, 1992; Stevens et al., 1999). From a public health perspective, there is increasing awareness of the impact of falls and fall-related injury morbidity in terms of rising health care costs and reductions in the quality of life for elderly people (AGS, 2001; Howland et al., 2001; Tinetti, 1994, 2003; Tinetti, Doucette, Claus, & Marottoli, 1995; Tinetti & Williams, 1997). A concomitant psychological symptom of falls is the fear of falling, which is common among older adults whether or not they have sustained a fall (Chandler, Duncan, Sanders, & Studenski, 1996; Lawrence et al., 1998; Myers et al., 1996; Tinetti, Speechley, & Ginter, 1988). A key public health concern is that fear of falling can result in self-induced restrictions in activity that could lead to muscle and lowerextremity strength depletion, thus restricting mobility and consequently reducing physical functioning (Arfken, Lach, Birge, & Miller, 1994; Bruce, Devine, & Prince, 2002; Chandler et al., 1996; Howland et al., 2001; Lachman et al., 1998; Maki, Holliday, & Topper, 1991; Tinetti, 1995; Vellas, Wayne, Romero, Baumgartner, & Garry, 1997)