Affective Correlates of Fear of Falling in Elderly Persons
ABSTRACT Fear of falling is common in older people, occurring on average in 50% of those who have fallen in the previous year. Little is known about the psychological correlates of fear of falling. The purpose of this study was to determine whether clinically significant depression and anxiety were independently associated with fear of falling.
This was a cross-sectional study of 105 persons age > or =60 years, admitted to medical or orthopedic wards, who had fallen at least once in the previous 12 months. Fear of falling was assessed using two different constructs: 1) intensity of fear; and 2) self-efficacy. Depressive and anxiety disorders were assessed with the Structured Clinical Interview for DSM-IV. Depression and anxiety severity were assessed with the Hospital Anxiety and Depression Scale. Demographic, physical, functional, and social variables previously found to be associated with fear of falling were also measured. Logistic-regression and multiple-regression analyses were used to examine the independent association of affective variables with fear of falling.
Depressive disorders, anxiety disorders, depression severity, and anxiety severity had significant independent associations with both constructs of fear of falling. Of all the variables that were measured, depressive disorders and depression severity had the strongest associations with fear of falling.
Affective variables had a stronger association with fear of falling than non-affective variables in a hospital-based group of subjects. Further research is needed to determine whether similar findings occur in a community-based sample of older people.
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ABSTRACT: The purpose of this study was to identify the characteristics associated with fear-induced activity restriction and determine those that distinguish older adults with fear-induced activity restriction from those with fear of falling alone. Data taken from the survey of the Korean Longitudinal Study of Aging in 2010 were analyzed. Multiple logistic regression analysis was used to assess factors associated with fear of falling and fear-induced activity restriction. A total of 22.5% of the participants reported no fear of falling, 48.6% reported fear of falling alone, and 28.9% reported fear-induced activity restriction. Characteristics independently associated with fear-induced activity restriction were low socioeconomic status, cognitive impairment, difficulty with activities of daily living, and a history of injurious falls. The differences between older adults with fear-induced activity restriction and those with fear of falling alone may guide refinement of intervention and preventive programs. © The Author(s) 2015.Journal of Aging and Health 03/2015; DOI:10.1177/0898264315573519 · 1.56 Impact Factor
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ABSTRACT: To examine whether depression predicts less improvement in fear of falling and falls efficacy in older adults attending a falls prevention program (FPP). Using a prospective observational design in an academic medical center, the authors studied 69 nondemented adults aged 55 years or older (mean age: 77.8 ± 8.9 years) who had experienced at least one fall in the previous year and who attended the FPP. The primary outcome variable was change in severity of fear of falling during the FPP. Secondary outcome variables were change in falls efficacy and fear-related restriction of activities during the FPP. Independent variables were baseline depressive disorders and depressive symptom severity. Twenty-one of 69 study participants (30.4%) had a depressive disorder at baseline. Depressive disorder and depressive symptoms were not associated with change in severity of fear of falling or restriction of activity. On the other hand, depressive disorder was associated with improvement in falls efficacy, although this finding was not significant in multivariate analysis. Among participants with a depressive disorder, improvement in falls efficacy was significantly correlated with improvement in depressive symptoms. There was no association between baseline depression and change in fear of falling in this FPP. The correlation between improvement in depressive symptoms and improvement in falls efficacy raises the question as to whether a cognitive-behavioral intervention that simultaneously targets both depression and falls efficacy would be a useful component of a FPP. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 02/2015; DOI:10.1016/j.jagp.2015.02.006 · 3.52 Impact Factor