title: Fear of falling and related activity restriction among middle-aged African Americans.
abstract: BACKGROUND
  The prevalence of fear of falling and related activity restriction, and their joint distribution with falls and falls efficacy, have been inadequately addressed in population-based studies of middle-aged and African-American groups.
  
  
  METHODS
  The African American Health project is a population-based panel study of 998 African Americans born in 1936-1950 from two areas of metropolitan St. Louis (an impoverished inner-city area and a suburban area). Fear of falling, fear-related activity restriction, and 24 frailty-related covariates were assessed during in-home evaluations in 2000-2001.
  
  
  RESULTS
  We found that 12.6% of participants reported having fear of falling without activity restriction, 13.2% had fear of falling with activity restriction, and 74.2% had no fear of falling. Neither fear of falling nor fear-related activity restriction varied significantly across three birth cohorts (1946-1950, 1941-1945, and 1936-1940). Lack of overlap of these two phenomena with having a fall in the past 2 years and low falls efficacy was considerable. When examined across three groups (no fear, fear without activity restriction, and fear with activity restriction), a consistent pattern of decreasing health status and social, emotional, and physical functioning was demonstrated.
  
  
  CONCLUSIONS
  In this population-based sample of 49- to 65-year-old African Americans, fear of falling and fear-related activity restriction were surprisingly common and not well explained by prior falls or low falls efficacy. These phenomena were already evident by age 49-55. Further study is warranted, including detailed qualitative investigations examining the timing, precursors, and consequences of fear of falling and fear-related activity restriction in minority and majority populations.
authors.affiliation: Division of Geriatric Medicine, St. Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, Missouri 53104, USA. wilsonmg@slu.edu
authors.forename: Margaret-Mary G
authors.initials: MM
authors.lastname: Wilson
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Miller
authors.forename: Elena M
authors.initials: EM
authors.lastname: Andresen
authors.forename: Theodore K
authors.initials: TK
authors.lastname: Malmstrom
authors.forename: J Philip
authors.initials: JP
authors.lastname: Miller
authors.forename: Fredric D
authors.initials: FD
authors.lastname: Wolinsky
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D012494:Sampling Studies; D017678:Sex Distribution; D013315:Stress, Psychological