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.
"It should be noted that in terms of the nature of the fall issue, some or all of the consequences may also cause another fall, which creates a vicious circle. For instance, the fear of falling  is one of the most mentioned fall causes, which is at the same time an important consequence of the fall. In addition, we consider a linear effect of the number of falls on the consequences, for instance on the lowering of quality of life. "
[Show abstract][Hide abstract] ABSTRACT: Assessing the number of users defined by a set of specific usage attributes in a given usage contextual situation is not always an obvious task in a market segmentation process. Although new approaches in design and marketing seem to be more sensitive to the adequacy of a design concept with the usage scenarios, these methods do not systematically consider the various usage situations. The present article puts forward a methodology intending to build a usage scenarios space in which the input data is thoroughly collected and validated. This methodology is applied to the complex and multifactorial issue of falls among the elderly in the Metropolitan France. In this paper, numerous medical publications have been made to study influential factors of fall situations. However, even solution providers for fall prevention and teleassistance ignore the real situational coverage of their solutions. As a result, “usage scenarios space” is built using an appropriate segmentation of usage contexts (here, fall situations) and user characteristics. These data are used for a design oracle to predict (simulate) the various and multiple usage scenarios.
"Although FoF may contribute to the risk of falling, it cannot be assumed that it represents the actual risk of falling . FoF is associated with anxiety, depressive symptoms, and reduced quality of life , and may lead to unnecessary avoidance of specific activities in older adults, even though they may be able to perform such activities without falling  . "
[Show abstract][Hide abstract] ABSTRACT: Little is known about dynamic balance control under dual-task conditions in older adults with fear of falling (FoF). The purpose of this study was to examine the effect of FoF on anticipatory postural adjustment (APA) during gait initiation under dual-task conditions in older adults. Fifty-seven elderly volunteers (age, 79.2 [6.8] years) from the community participated in this study. Each participant was categorised into either the Fear (n=24) or No-fear (n=33) group on the basis of the presence or absence of FoF. Under single- and dual-task conditions, centre of pressure (COP) data were collected while the participants performed gait initiation trials from a starting position on a force platform. We also performed a 10-m walking test (WT), a timed up & go test (TUG), and a functional reach test (FR). The reaction and APA phases were measured from the COP data. The results showed that under the dual-task condition, the Fear group had significantly longer APA phases than the No-fear group, although no significant differences were observed between the 2 groups in the reaction and APA phases under the single-task condition and in any clinical measurements (WT, TUG, and FR). Our findings suggest that specific deficits in balance control occur in subjects with FoF during gait initiation while dual tasking, even if their physical functions are comparable to subjects without FoF.
"The link between fear of falling and falls seems to go both ways: fear of falling is more frequent amongst fallers and people feeling this fear are more at risk of falling . This increase in the risk of falling would be linked, according to some authors, to the activity restriction brought about by this fear [5,8,13,14], a restriction that may cause, amongst other things, muscle atrophy , deconditioning [5,13,14] and worse balance . And, this in turn could feed the fear and avoidance . "
[Show abstract][Hide abstract] ABSTRACT: This article aims at describing, in a Belgian town, the frequency of the fear of falling and of subsequent activity restriction among non-institutionalised people aged 65 years and over, and at identifying persons affected by these two issues.
Cross-sectional survey conducted in Fontaine l'Evêque (Belgium) in 2006, using a self-administered questionnaire.
The participants could fill in the questionnaire on their own or with the help of a third party if needed. The latter were not taken into account in this article. Analyses covered 419 questionnaires. Fear of falling and activity restriction were reported by, respectively, 59.1% and 33.2% of participants. They were more frequent among fallers but also affected non-fallers. In logistic regression analyses: gender, the fact of living alone and the number of falls were significantly associated with fear of falling; gender, age and the number of falls were significantly associated with activity restriction.
Our study, despite various limitations, shows the importance of fear of falling and of subsequent activity restriction among older people, among fallers as well as among non-fallers. It also provides information, though limited, concerning persons affected by these two issues in Belgium, and in other contexts as well. Given the ageing of our populations, it is important to take these problems into account when caring for older people.
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