Self-awareness of falls risk among elderly patients: characterizing awareness deficits and exploring associated factors

Objective To characterize self-awareness in older adults undergoing inpatient rehabilitation and explore factors associated with reduced awareness of falls risk. Design Prospective, cross-sectional design. Setting Older adult inpatient rehabilitation setting. Participants Rehabilitation inpatients (N=91; mean age, 77.97?8.04y) and their treating physiotherapist. Interventions None. Main Outcome Measures Three aspects of self-awareness (intellectual, emergent, anticipatory) were measured using the Self-Awareness of Falls Risk Measure. Demographic, medical, and cognitive (Mini-Mental State Examination) information were collected. Current ability was measured using the FIM and timed Up and Go test. Results Of the patients in the sample, 31 to 63 underestimated falls risk and 3 to 10 overestimated falls risk depending on the aspect of awareness measured. Different aspects of reduced self-awareness were correlated with being a man, higher educational attainment, neurologic history, lower cognitive ability, and lower functional ability. Regression analysis indicated that sex (?=-.33, P=.004), education (?=-.30, P=.006), and neurologic history (?=-.22, P=.038) were independently associated with overall self-awareness. Conclusions 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 effects 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