Fear of Falling Raises the Risk of Falling

Fear of falling – also called basophobia - is a recognized psychological entity that’s been associated with an increased likelihood of falls in the victim.  In the elderly, the fear can lead to decreased mobility and hence increased frailty, thus raising the risk of falling.  Therefore Australian and Belgian researchers have studied the differences between actual and perceived fall risk when assessing the best ways to prevent falls in the elderly.  They have published their findings in the British Medical Journal.

The participants in the study were 500 men and women aged 70 to 90, living in Sydney, Australia.  At enrollment they underwent medical, physiological, and neuropsychological exams, using recognized and generally-accepted scoring scales.  They were followed-up for reports of falls, monthly for 12 months.

The participants were classified into 4 named groups, based on their actual (physiological) and perceived (fear-of-falling) risk:

Vigorous – low actual and low perceived fall risk

Aware – high actual and high perceived fall risk

Anxious – low actual but high perceived fall risk

Stoic – high actual and low perceived fall risk

The Vigorous were considered to be at low risk for future falls.  The Aware were considered to be at high risk, as were the Anxious.   The Stoic group, however, gathered some degree of protection from their positive outlook, community activities, and low perceived risk, and were in fact at low risk of future falls.

The consequences of this research?  Fear of falling should be included in risk-of-falling assessments, as well as actual fall risks, such as mobility issues, neurological problems, or frailty.  This ought to allow interventions intended to prevent falls to be tailored to the subject’s risk profile, with a greater chance of success.  (Of course, this assumes a suitable treatment for fear of falling, which wasn’t mentioned by the authors.  What might it be? Cognitive behavioral therapy, hypnosis, or tai chi?)