Self-Awareness of Falls Risk among Elderly Patients: Characterizing Awareness Deficits and Exploring Associated Factors

The objective of this study was to characterize self-awareness in older adults undergoing inpatient rehabilitation and explore factors associated with reduced awareness of falls risk. Ninety-one rehabilitation inpatients (Mage=77.97, SD=8.04) and their treating physiotherapist were utilised for this study in a rehabilitation centre. Three aspects of self-awareness (intellectual, emergent and anticipatory) were measured using the Self-Awareness of Falls Risk Measure. Demographic, medical and cognitive (Mini-Mental State Examination) information was collected. Current ability was measured using the Functional Independence Measure and Timed Up-and-Go test. Thirty-one to 63 percent of patients in the sample underestimated falls risk and three to 10 percent overestimated falls risk depending on the aspect of awareness measured. Different aspects of reduced self-awareness were correlated with male gender, higher educational attainment, neurological history, lower cognitive ability and lower functional ability. Regression analysis indicated that gender (β = -.33, p = .004), education (β = -.30, p = .006) and neurological history (β = -.22, p = .038) were independently associated with overall self-awareness.

The results suggest that a proportion of older adults undergoing inpatient rehabilitation underestimate personal falls risk. Further research is required to investigate the contributors to, and effect of, reduced self-awareness of falls risk. Greater understanding of these factors will facilitate the development of strategies to increase awareness of falls risk and increase engagement in falls prevention.

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