Psychological, physical, and sensory correlates of fear of falling and consequent activity restriction in the elderly: the InCHIANTI study.
OBJECTIVE
To identify psychological, physical, and sensory function parameters that are specifically associated with fear of falling (FF) and fear-induced activity restriction in a population-based sample of older adults.


METHODS
FF, fear-induced activity restriction, cognition, depression, personal mastery, chair-stand performance, standing balance, lower-limb and grip strength, visual acuity and contrast sensitivity, and vibrotactile sensitivity were evaluated in the population-based, older cohort (n = 926, age > or = 65) enrolled in the InCHIANTI study.


RESULTS
Nearly 50% participants reported FF. Of these, 65% reported some activity restriction. Personal mastery (P < 0.001) and chair-standing performance (P = 0.001) were independently associated with FF. In those who did not have depression, personal mastery, standing balance, lower-limb strength, and visual contrast sensitivity were associated with activity restriction (P < 0.001-0.011). In those who were depressed, total FF was the major factor strongly associated with activity restriction (P < 0.001), with marginal but significant associations for cognition (P = 0.027) and standing balance (P = 0.015).


CONCLUSIONS
Psychological and physical factors are independently associated with FF. Presence of depression possibly modulates which factors, in addition to fear of falling, affect fear-induced activity restriction. A longitudinal study is warranted to substantiate causal relationships.
Deshpande
Nandini
N
University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
Metter
E Jeffrey
EJ
Bandinelli
Stefania
S
Lauretani
Fulvio
F
Windham
B Gwen
BG
Ferrucci
Luigi
L
D000058:Accidental Falls; D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D015331:Cohort Studies; D015350:Contrast Sensitivity; D003430:Cross-Sectional Studies; D003863:Depression; D005239:Fear / Q000523:psychology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D007389:Internal-External Control; D008297:Male; D051346:Mobility Limitation; D004856:Postural Balance