Objective: Fear of falling is a common problem in the elderly occurring, on average, in 50% of persons who have fallen in the previous year. It is frequently associated with avoidance of activities, which can result in physical and functional decline. To date, studies that have examined correlates of fear of falling have focused on sociodemographic, physical and functional variables. Our objective was to determine whether depression, anxiety, and dysfunctional attitudes relate independently to fear of falling.
Design: A cross-sectional study using a convenience sample of non-demented persons aged 60 years or older admitted to medical and surgical wards who had experienced at least one fall in the previous 12 months.
Materials and Methods: Psychological variables were assessed using the Structured Clinical Interview for DSM-IV, the Hospital Anxiety and Depression Scale, and the Dysfunctional Attitudes Scale. Fear of falling was assessed categorically (no and slight fear vs. moderate and severe fear) and continuously using the Modified Falls Efficacy Scale. Several other variables (e.g. age, sex, dizziness, vision, balance and mobility, delay getting up after a fall, fall associated with a fracture) previously found to be associated with fear of falling were also measured. Multiple linear regression was used for the continuous dependent variable and logistic regression for the dichotomous dependent variable.
Results: The sample included 105 respondents (mean age 78.2, SD 8.9; 86.7% female). Depression severity, depressive disorders, anxiety severity, anxiety disorders, and dysfunctional attitudes each related independently to fear of falling as measured both continuously and categorically. Of all the psychological and non-psychological variables that were entered into the regression models, depression severity and depressive disorders accounted for the greatest proportion of the variance in fear of falling.
Conclusion: Depression, anxiety, and dysfunctional attitudes relate significantly and uniquely to fear of falling. Depression had the strongest association with this fear. Increased understanding of psychiatric correlates of fear of falling could lead to more effective means of prevention and treatment.
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