The correlation between falls efficacy and activities of daily living among older adults receiving different types of care: a 2018–2019 cross-sectional study in Shanghai, China

BACKGROUND: Falls in older adults has become a significant public health concern worldwide. Falls-related self-efficacy is closely related to healthy aging. This study investigated older adults receiving different types of care to clarify the correlation between falls efficacy and Activies of Daily Living (ADL), providing a theoretical basis for achieving healthy aging. METHODS: An investigation comparing older adults attending senior day care centers and healthy older adults staying at home in the community was carried out by using structured questionnaires, including individual participants’ data, Falls Efficacy Scale International (FES-I), Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7 and Lawton Instrumental Activities of Daily Living Scale (Lawton IADLs). RESULTS: A total of 336 older adults were enrolled, and 153 (45.5%) older adults attending senior day care centers daily. The FES-I score of all the respondents was 30.65 ± 13.892, while the scores of healthy older adults staying at home in the community and attending senior day care centers were 25.05 ± 10.036 and 37.35 ± 14.894, respectively (p < 0.05). Among healthy older adults staying at home in the community, those using walking aids (OR = 53.595, 95%CI: 8.181, 351.129), with fear of falling (OR = 5.909, 95%CI:1.374, 25.407) and with anxiety symptoms (OR = 23.620, 95%CI: 6.077, 91.802) had low falls efficacy. Among older adults attending senior day care centers daily, those with higher education levels had high falls efficacy (OR = 0.276, 95%CI: 0.088, 0.862), and those with poor sleep quality (OR = 4.469, 95%CI: 0.682, 29.312), comorbidities (OR = 9.820, 95%CI: 1.990, 48.456), and with severe depressive symptoms (OR = 3.680, 95%CI: 1.098, 12.335) had low falls efficacy. The older adults with a higher score of Lawton IADLs had higher falls efficacy. CONCLUSIONS: Older adults attending senior day care centers daily had lower falls efficacy and needed to be paid more attention to in fall prevention. Targeted health promotion activities were necessary for older adults to improve their falls efficacy to achieve healthy aging.