Psychological, Physical, and Sensory Correlates of Fear of Falling and Consequent Activity Restriction in the Elderly

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Abstract
Deshpande N, Metter EJ, Bandinelli S, Lauretani F, Windham BG, Ferrucci L: Psychological, physical, and sensory correlates of fear of falling and consequent activity restriction in the elderly: the InCHIANTI study. Am J Phys Med Rehabil 2008;87:354–362. 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. Design: 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 ≥ 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). Conclusion: 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.