The risk of being fearful or fearless of falls in older people: an empirical validation.
OBJECTIVE
To investigate the risk of being fearful or fearless of falls in older people.


METHODS
Using a force plate, postural control in different sensory and rhythmic conditions was measured in 263 community-dwelling older people. Other assessments included fear of falling, and handgrip strength. Fall incidence was assessed at baseline and during a one-year follow-up period.


RESULTS
Logistic regression analysis revealed that increased lateral sway in near-tandem stance with eyes open (OR = 5.33; p < 0.01) and a worse performance on anteroposterior rhythmic weight shifts (OR = 0.65; p < 0.05) were related to falls. Univariate analyses revealed that older people with inappropriate high fear of falling according to their fall incidence had worse balance capacities on the rhythmic weight shifts (p < 0.05) but had similar static balance and physical capacities. Older people with inappropriate low fear of falling had a better hand grip (p < 0.05) but equally worse balance capacities than the comparison group.


CONCLUSIONS
The results indicate the importance of lateral stability in relation to falls. They also suggest a substantial impact of inappropriate fear of falling on physical performance. Inappropriate high fear of falling may result in worse performance during dynamic balance tests, whereas older people with inappropriate low fear seem to overrate their capacities because of higher strength.
Delbaere
Kim
K
Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Belgium. Kim.Delbaere@UGent.be
Crombez
Geert
G
Van Den Noortgate
Nele
N
Willems
Tine
T
Cambier
Dirk
D
D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000375:Aging; D005239:Fear; D016330:Frail Elderly; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D004856:Postural Balance; D011597:Psychomotor Performance; D012044:Regression Analysis; D012107:Research Design; D012306:Risk; D011795:Surveys and Questionnaires