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Background <p>Hip fractures in older adults have become a global public health challenge. Such fractures not only carry a high mortality rate but also severely impair patients' mobility. Although it is known that fear of falling affects mobility recovery, existing evidence has largely focused on short-term outcomes within the first year post-surgery. The persistent impact of preoperative fear of falling on long-term mobility at three years post-surgery remains unclear. This study aims to evaluate the impact of preoperative fear of falling on mobility and health-related quality of life at three years postoperatively in elderly patients with hip fractures.</p> Methods <p>A post-hoc analysis of a prospective study was done. Patients aged 65&#xa0;years and above with hip fractures who underwent surgical treatment at Beijing Jishuitan Hospital between November 2018 and November 2019 were enrolled. Preoperative fear of falling was assessed using the Modified Fall Effectiveness Scale (MFES). Patients were categorized into low (MFES ≥ 8) and high (MFES &lt; 8) fear groups. The primary outcome of this study was mobility at 3-year post-surgery. Secondary outcomes comprised mobility at 30-day, 120-day, and 1-year post-surgery, alongside quality of life at 30-day, 120-day, 1-year, and 3-year post-surgery.</p> Results <p>A total of 683 patients were ultimately included in the analysis. There were statistically significant differences between the two groups in age, gender, educational level, hypertension, stroke, pre-fracture mobility, anesthesia method, and length of hospital stay (all <i>P</i> &lt; 0.05). There were no significant differences in mobility or EQ-5D index between groups within first year post-surgery (all adjusted <i>P</i> &gt; 0.05). However, statistically significant differences in mobility and EQ-5D index were observed between the two groups at the 3-year follow-up. Patients with low preoperative fear of falling demonstrated higher mobility and EQ-5D index at 3&#xa0;years (all adjusted&#xa0;<i>P</i> &lt; 0.001).</p> Conclusion <p>The preoperative fear of falling was significantly associated with mobility and quality of life three years postoperatively in elderly hip fracture patients.</p>

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Pre-operative fear of falling is associated with worse 3-year mobility and quality of life in elderly hip fracture patients: a post-hoc analysis of a prospective cohort

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  • 发表日期：

    2026年6月1日

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  • Feng Gao,
  • Shanbin Xu,
  • Yimin Chen,
  • Liunan Chen,
  • Ruijiang Li,
  • Yixiao Chen,
  • Mingjian Bei,
  • Tingrun Cui,
  • Gang Liu,
  • Minghui Yang,
  • Xinbao Wu

摘要

Background

Hip fractures in older adults have become a global public health challenge. Such fractures not only carry a high mortality rate but also severely impair patients' mobility. Although it is known that fear of falling affects mobility recovery, existing evidence has largely focused on short-term outcomes within the first year post-surgery. The persistent impact of preoperative fear of falling on long-term mobility at three years post-surgery remains unclear. This study aims to evaluate the impact of preoperative fear of falling on mobility and health-related quality of life at three years postoperatively in elderly patients with hip fractures.

Methods

A post-hoc analysis of a prospective study was done. Patients aged 65 years and above with hip fractures who underwent surgical treatment at Beijing Jishuitan Hospital between November 2018 and November 2019 were enrolled. Preoperative fear of falling was assessed using the Modified Fall Effectiveness Scale (MFES). Patients were categorized into low (MFES ≥ 8) and high (MFES < 8) fear groups. The primary outcome of this study was mobility at 3-year post-surgery. Secondary outcomes comprised mobility at 30-day, 120-day, and 1-year post-surgery, alongside quality of life at 30-day, 120-day, 1-year, and 3-year post-surgery.

Results

A total of 683 patients were ultimately included in the analysis. There were statistically significant differences between the two groups in age, gender, educational level, hypertension, stroke, pre-fracture mobility, anesthesia method, and length of hospital stay (all P < 0.05). There were no significant differences in mobility or EQ-5D index between groups within first year post-surgery (all adjusted P > 0.05). However, statistically significant differences in mobility and EQ-5D index were observed between the two groups at the 3-year follow-up. Patients with low preoperative fear of falling demonstrated higher mobility and EQ-5D index at 3 years (all adjusted P < 0.001).

Conclusion

The preoperative fear of falling was significantly associated with mobility and quality of life three years postoperatively in elderly hip fracture patients.