How Does Fear of Falling Affect People in Middle Age?

MIAMI—Healthy, middle-aged adults may have a fear of falling, but unlike in older adults, this fear does not appear to affect gait and balance, according to a study presented at the Second Pan American Parkinson’s Disease and Movement Disorders Congress.

Maria Sheila G. Rocha, MD, PhD

Since ptophobia, the fear of standing or walking, was described in the 1980s, “fear of falling has gained recognition as a health problem of older adults,” said Maria Sheila G. Rocha, MD, PhD, a researcher at Hospital Santa Marcelina in São Paulo, Brazil, and colleagues. In adults older than 65, fear of falling increases the likelihood of falls and injury and limits daily activities. The incidence and impact of fear of falling in younger adults is not known, however.

Dr. Rocha and colleagues aimed to evaluate the prevalence of fear of falling among urban, middle-aged, healthy adults, as well as associated risk factors and fear of falling’s impact on gait and balance in this population.

Their study included 111 healthy participants ages 18 to 95 who lived in São Paulo. The investigators assessed fear of falling using the following four variables from the Brazilian version of the Falls Efficacy Scale-International: history of falls, functional dependency in activities of daily living, cognitive screening test, and activity level. The researchers assessed gait and balance using the Berg Balance Scale, Dynamic Gait Index, Short Physical Performance Battery, and the Performance Oriented Mobility Assessment.

Of the 111 participants, 52.2% were female, mean age was 51.8, and mean Mini-Mental State Examination score was 29.5. Fear of falling was present in 25.2%, and prevalence increased with age. Fear of falling was present in 18.4% of adults younger than 65 and in 48% of those 65 and older.

Fear of walking on an uneven surface and fear of going up or down a slope were the most common fear of falling variables. Being female and older were the main risk factors associated with fear of falling.

Participants with fear of falling performed worse on the Berg Balance Scale and Short Physical Performance Battery than those without. Those younger than 65, however, “had similar gait and balance performance despite the presence of fear of falling,” Dr. Rocha and colleagues said. In addition, physically active participants had less fear of falling.

“Fear of falling creates a psychologic barrier to performing activities for many older adults,” Dr. Rocha and colleagues said. The results suggest that physical activity is a protective factor against fear offalling, the researchers concluded.