Fear of Falling Can Lead to Falls, Researchers Conclude

Cheryl Clark, for HealthLeaders Media , August 23, 2010

Although most of those participating in the project had an accurate perception of their fall risk, one third of the participants "had disparities between their perceived and physiological fall risk," the researchers wrote.

For example, of the 198 who had a low physiological risk of falls based on their physical condition, history of prior falls, medication use, and other factors, 54 perceived that they would fall (the "anxious" group). And of those, 21 (39%) actually did, indicating that their fear may have played a part in that occurrence.

"Despite their low physiological fall risk, almost 40% of the anxious group experienced multiple or injurious falls during the one-year follow-up," the researchers wrote. "The disparity between physiological and perceived fall risk in the anxious group seemed to be strongly related to psychological factors."

And, the researchers wrote, the group's psychological profile indicated "a higher prevalence of irrational fears (higher levels of neuroticism) possibly leading them to interpret small balance impairments as major deteriorations in balance control.)

Likewise, of the 302 with a high physiological fall risk, 100 (the stoic group) didn't think they were at risk of falling, and of that group, 34 (20%) actually fell. The researchers acknowledged that they "initially hypothesized that an inaccurately low perception of fall risk would lead to a higher rate of injurious and multiple falls through risk-taking behavior or poor insight." But these participants' psychological profile did not indicate excessive risk-taking, "but rather a positive attitude to life, emotional stability, and low reactivity to stress."

And the researchers wrote, the low perception of fall risk in the stoic group "seemed to be protective towards future falls compared with the aware group," perhaps because they were more active and thus had better muscle strength, used fewer psychotropic medication, or had not had a prior fall.

The Australian researchers had several limitations in their report. For starters, they followed the patients for one year, so falls in any of the groups that occurred after that period would not have been reflected. Also, all psychological profile information was by self-report from the seniors, and the physiological profile assessment, they acknowledged, was only an estimate.

The authors received funding from the Australian National Health and Medical Research Council.

See Also:
Success With a Fall Reduction Strategy
Maryland Program Provides Road Map for Reducing Patient Falls
Falls Cause Most Injury-Related Deaths in WI
What prevents falls after strokes? Study: Not much

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