Effects of a multicomponent cognitive behavioral group intervention on fear of falling and activity avoidance in community-dwelling older adults: results of a randomized controlled trial.
OBJECTIVE
To evaluate the effects of a multicomponent cognitive behavioral intervention on fear of falling and activity avoidance in older adults.


METHODS
Randomized controlled trial.


METHODS
Community-dwelling adults in the Netherlands.


METHODS
Five hundred forty adults aged 70 and older who reported fear of falling and fear-induced activity avoidance (280 intervention, 260 control).


METHODS
A multicomponent cognitive behavioral group intervention consisting of eight weekly sessions and a booster session. The sessions were aimed at instilling adaptive and realistic views on falls, reducing fall risk, and increasing activity and safe behavior.


METHODS
Data on fear of falling, activity avoidance, concerns about falling, perceived control over falling, and daily activity were collected at baseline and at 2, 8, and 14 months.


RESULTS
At 2 months, there were significant between-group differences in fear of falling (odds ratio (OR)=0.11; P<.001), activity avoidance (OR=0.26; P<.001), concerns about falling (adjusted mean difference=-1.51; P=.02), and daily activity (adjusted mean difference=0.95; P=.01). At 8 months, there were significant between-group differences in all outcomes and at 14 months in fear of falling (P=.001), perceived control over falling (P=.001), and recurrent fallers (P=.02) but not in activity avoidance (P=.07), concerns about falling (P=.07), daily activity (P=.24), or fallers (P=.08).


CONCLUSIONS
This multicomponent cognitive behavioral intervention showed positive and durable effects on fear of falling and associated activity avoidance in community-dwelling older adults. Future research should focus on improving intervention uptake and adherence, reaching frailer populations, and determining potential intervention effects on functional outcomes.
Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences, CAPHRI-School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. r.zijlstra@zw.unimaas.nl
G A Rixt
GA
Zijlstra
Jolanda C M
JC
van Haastregt
Ton
T
Ambergen
Erik
E
van Rossum
Jacques Th M
JT
van Eijk
Sharon L
SL
Tennstedt
Gertrudis I J M
GI
Kempen
D000058:Accidental Falls / Q000517:prevention & control*; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001362:Avoidance Learning; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D009426:Netherlands; D011615:Psychotherapy, Group / Q000379:methods*; D012934:Social Isolation