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Does pride really come before a fall?
 — Longitudinal analysis of older English adults
Author(s)D McMinn, S J Fergusson, M Daly
Journal titleBMJ 2017;359:j5451, 20 November 2017
Pages6 pp
Full text*http://www.bmj.com/content/bmj/359/bmj.j5451.full.pdf
AnnotationThe fifth wave of the English Longitudinal Study of Ageing (ELSA, 2010/11) measured levels of pride in the self-completion questionnaire with this question: "During the past 30 days, to what degree did you feel proud?" The authors tested whether high levels of reported pride are associated with subsequent falls, using data for the 4964 participants available for follow-up at wave 7 of ELSA (2014/15). Their findings did not support the contention that "pride comes before a fall". Unadjusted estimates indicate that the odds of reported falls were significantly lower for people with high pride levels, compared with those who had low pride (odds ratio 0.69, 95% confidence interval 0.58 to 0.81, P<0.001). This association remained after adjusting for age, sex, household wealth, and history of falls (odds ratio 0.81, 0.68 to 0.97, P<0.05). It was partially attenuated after further adjustment for mobility problems, eyesight problems, the presence of a limiting long-term illness, a diagnosis of arthritis or osteoporosis, medication use, cognitive function, and pain and depression (odds ratio 0.86, 0.72 to 1.03, P<0.1). Because the confidence interval exceeded 1 in the final model, it remains possible that pride may not be an independent predictor of falls when known risk factors are considered. People with moderate pride did not have lower odds of having fallen than those with low pride in adjusted models. Participants lost to follow-up did not differ from those retained in terms of key variables, and weighting the analyses to account for selective attrition did not produce different results. People with higher levels of pride seem to be at lower risk of falling, so that these findings suggest that pride may actually be a protective factor against falling in older adults, rather than an antecedent. (RH).
Accession NumberCPA-171219002 A
ClassmarkOLF: DP: 49: 3J: 82 *
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