Associations between the impact of menopausal symptoms and fall-related self-efficacy

Abstract

Objective: To analyze the association between the severity of menopausal symptoms and two important fall risk factors, namely balance confidence and fear of falling, among Portuguese and Spanish postmenopausal women aged ≥ 65 years. Methods: A cross-sectional, observational study was conducted on 363 women (66.21 ± 9.00 years) from several Portuguese and Spanish locations. The Menopause Rating Scale (MRS) was used to evaluate the severity of menopausal symptoms, while the Falls Efficacy Scale-International and Activities-specific Balance Confidence Scale-16 items were used to assess balance confidence and fear of falling, respectively. Anxiety and depression (evaluated by the Hospital Anxiety and Depression Scale), age, time since the onset of menopause, body mass index (BMI), history of falls, osteoporosis, smoking habit, physical activity level, and nocturia were considered as potential confounders. Independent associations were analyzed after adjusting for potential confounding variables. Student’s t test, bivariate correlations and multivariate linear regression analysis were performed. Results: A total of 363 women (66.21 ± 9.00 years) participated in the study, 192 from Portugal and 171 from Spain. Linear regression analysis indicates that more severe menopausal symptoms at a somato-vegetative level (beta coefficient (β) = -0.25; 95% confidence interval (95% CI):-2.09 to -0.81; p = <0.001), a higher BMI (β = -0.16; 95% CI:-1.22 to -0.22; p = 0.005), and osteoporosis (β = 0.14; 95% CI: 1.36 to 10.08; p = 0.010) were associated with lower balance confidence values. On the other hand, a higher score in the MRS somato-vegetative domain (β = 0.22; 95% CI: 0.27 to 0.79; p = <0.001), depression (β = 0.36; 95% CI: 0.59 to 1.08; p = <0.001), and years after the menopause onset (β = 0.15; 95% CI: 0.04 to 0.22; p = 0.006) were linked to increased fear of falling. Conclusions: The findings of our study show that, after taking into account possible confounders, increased severity of menopausal symptoms at a somatic level was associated with heightened fear of falling and diminished balance confidence.