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PhD Studentship – Is fear of falling the key to identifying, and improving outcomes for, older adults with gait and balance abnormalities?

A fully-funded PhD studentship with the NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC), sponsored by Newcastle University.

Starting September 2021 for three years.

More about this PhD

Falls are common in community dwelling older people, occurring in around 30% of those over 65 years of age, with around 1:10 of these resulting in fractures. Gait and balance abnormalities (GABAb) are a key modifiable risk factor through strength and balance training.

In addition, there is a strong relationship between fear of falling (FoF), the complex of psychosocial issues surrounding concerns about falling and GABAb which is associated with increasing falls risk, reduced independence and increased mortality.

One of the most commonly used instruments to assess FoF is the Falls Efficacy Scale-International version (FES-I). Retrospective analysis of almost 4000 individuals attending our community falls service showed that FoF as measured by the FES-I is associated with scores on commonly used gait and balance tests that indicate a high risk of falling.

These data and findings highlight the potential of using FES-I as a screening tool to identify community dwelling older adults at risk of falling who may benefit from strength and balance training, in place of physical tests that are rarely performed outside falls clinics and physiotherapy departments.

In the face of an ageing population, the financial costs of falling in older adults represent a significant burden to the National Health Service. Identification of and subsequent intervention with older adults at risk of falling has been shown to be cost-effective: The reduced care need exceeds the costs of screening and intervention. However, no information exists about the relative cost-effectivenss of FES-I as a mechanism to identify and improve outcomes compared to other commonly used diagnostics.

This PhD provides the opportunity to further evaluate the FES-I as a screening tool in older adults at risk of falling. A mixed methods evaluation, including a health economic dimension is envisaged.

Find out more and apply

Closing date 16 May 2021