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The Gerontologist 46:249-257 (2006)
© 2006 The Gerontological Society of America

Cross-Sectional and Longitudinal Risk Factors for Falls, Fear of Falling, and Falls Efficacy in a Cohort of Middle-Aged African Americans

Elena M. Andresen, PhD1,2, Fredric D. Wolinsky, PhD3,4, J. Philip Miller, AB5, Margaret-Mary G. Wilson, MD6, Theodore K. Malmstrom, PhD7 and Douglas K. Miller, MD8

Correspondence: Address correspondence to Elena M. Andresen, PhD, College of Public Health and Health Professions, University of Florida Health Sciences Center, P.O. Box 100182, Gainesville, FL 32610-0182. E-mail: eandresen{at}

Purpose: The purpose of this study is to cross-sectionally and longitudinally identify risk factors for falls, fear of falling, and falls efficacy in late-middle-aged African Americans. Design and Methods: We performed in-home assessments on a probability sample of 998 African Americans and conducted two annual follow-up interviews. Multiple logistic regression modeled the associations with falls (any fall or injurious fall) during 2 years prior to the baseline interview, and baseline fear of falling and falls efficacy with 2-year prospective risks for falling and fear of falling. Results: The most consistent association for all outcomes was depressive symptoms. Age was associated with increased risk of prior and prospective falls. Lower-body functional limitations were associated with prior falls, baseline fear of falling, and low falls efficacy, whereas low ability with one-leg stands prospectively predicted fear of falling. The greatest prospective risk for incident falls was having had a prior fall (odds ratio = 2.51), and the greatest prospective risk for fear of falling was having been afraid of falling at baseline (odds ratio = 8.14). Implications: Falls, fear of falling, and low falls efficacy are important issues for late-middle-aged as well as older persons. Interventions should focus on younger adults and attend especially to lower-body function and depressive symptoms as well as building self-efficacy for safe exercise, dealing with falls risks, and managing falls themselves.

Key Words: Balance • Strength • Mobility • Functional status • Quality of life

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Copyright © 2006 by The Gerontological Society of America.