Gender-based distribution of geriatric syndromes and determinants of fear of falling in older adults attending a geriatrics outpatient clinic

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Abstract
Introduction: Geriatric syndromes are important clinical conditions that are common in elderly individuals, usually occur as a result of the interaction of more than one system, and negatively affect elderly health. Early identification of risk factors associated with these syndromes and timely implementation of appropriate interventions may contribute to the prevention of future health problems. Fear of falling is a significant risk factor that affects the quality of life in older adults both directly and indirectly. In this study, we aimed to evaluate the distribution of geriatric syndromes by gender and their association with fear of falling.Methods: This study was conducted by retrospectively analyzing the data of comprehensive geriatric assessment performed by a geriatrician in individuals aged 65 years and older who applied to the geriatric outpatient clinic of a tertiary hospital between June 2023 and August 2024. Demographic characteristics of the participants [age, sex, education level (≤5 years, >5 years), and living alone status], comorbidities, and geriatric syndromes were recorded. Within the scope of geriatric syndromes, the following were assessed: functional status [activities of daily living (ADL) and instrumental activities of daily living (IADL)], frailty, sarcopenia, nutritional status, depressive symptoms, cognitive function, sleep disorders, urinary incontinence, history of falls, fear of falling, and polypharmacy.Participants were divided into two groups based on the presence of fear of falling, and logistic regression analysis was performed to identify factors independently associated with fear of falling.Results: A total of 294 patients were included in the study (68.4% female; mean age 76.14 ± 6.77 years). Among the geriatric syndromes, dependence in instrumental activities of daily living (IADL), frailty, sarcopenia, cognitive impairment, urinary incontinence, and fear of falling were more frequently observed in women (p=0.032, 0.030, 0.014, 0.020, 0.011, and 0.034, respectively), while nutritional problems were more prevalent in men (p=0.031).The prevalence of fear of falling was found to be 46.6%. Fear of falling was significantly associated with dependence on basic and instrumental activities of daily living (ADL/IADL), frailty, sarcopenia, depression, urinary incontinence, and history of falls. Age, frailty, history of falls, and depression were identified as independent predictors of fear of falling (p<0.001, 0.016, <0.001, and 0.001, respectively).Conclusion: The fact that certain geriatric syndromes are more commonly seen in women may suggest that greater attention should be given to the health needs of older women. Early recognition of modifiable risk factors, such as fear of falling, may contribute to the prevention of frailty and depression. Screening and proper management of this risk factor, especially in primary healthcare settings frequently accessed by older adults, can significantly contribute to improving their quality of life. Prospective multicenter studies are needed to establish causality.

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