title: Fall-Related Psychological Concerns and Anxiety among Community-Dwelling Older Adults: Systematic Review and Meta-Analysis.
abstract: Fear of falling and other fall-related psychological concerns (FRPCs), such as falls-efficacy and balance confidence, are highly prevalent among community-dwelling older adults. Anxiety and FRPCs have frequently, but inconsistently, been found to be associated in the literature. The purpose of this study is to clarify those inconsistencies with a systematic review and meta-analysis and to evaluate if the strength of this relationship varies based on the different FRPC constructs used (e.g., fear of falling, falls-efficacy or balance confidence). A systematic review was conducted through multiple databases (e.g., MEDLINE, PsycINFO) to include all articles published before June 10th 2015 that measured anxiety and FRPCs in community-dwelling older adults. Active researchers in the field were also contacted in an effort to include unpublished studies. The systematic review led to the inclusion of twenty relevant articles (n = 4738). A random-effect meta-analysis revealed that the mean effect size for fear of falling and anxiety is r = 0.32 (95% CI: 0.22-0.40), Z = 6.49, p < 0.001 and the mean effect size for falls-efficacy or balance confidence and anxiety is r = 0.31 (95% CI: 0.23-0.40), Z = 6.72, p < 0.001. A Q-test for heterogeneity revealed that the two effect sizes are not significantly different (Q(19) = 0.13, p = n.s.). This study is the first meta-analysis on the relationship between anxiety and FRPCs among community-dwelling older adults. It demonstrates the importance of considering anxiety when treating older adults with FRPCs.
authors.affiliation: Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada.|Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.|Laboratoire d'Étude sur l'Anxiété et la Dépression gÉRiatrique (LEADER), Montreal, Quebec, Canada.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Payette
authors.affiliation: Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada.|Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
authors.forename: Claude
authors.initials: C
authors.lastname: Bélanger
authors.affiliation: Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.|Laboratoire d'Étude sur l'Anxiété et la Dépression gÉRiatrique (LEADER), Montreal, Quebec, Canada.|Department of Psychology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Léveillé
authors.affiliation: Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.|Laboratoire d'Étude sur l'Anxiété et la Dépression gÉRiatrique (LEADER), Montreal, Quebec, Canada.|Department of Psychology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Grenier
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology* / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008875:Middle Aged; D004856:Postural Balance; D017594:Publication Bias; D020377:Self Efficacy