Fear of falling is common in older adults. Fear of falling may exacerbate impaired mobility and contribute to functional dependency. The relationship between the degree of fear of falling and impaired locomotion is, however, poorly understood. To better understand the factors that contribute to fear of falling, we tested the hypothesis that fear of falling is associated with locomotion disturbances, more specifically, with the stride-to-stride variability of gait. To assess this hypothesis, we studied patients with High Level Gait Disturbances in whom fear of falling is a leading symptom, often causing significant disability. Fear of falling was evaluated using the Activities-specific Balance Confidence (ABC) Scale (possible range 0-100). General anxiety, depression and cognitive function were assessed using Spielberger’s State-Trait Personality Inventory , the Geriatric Depression Scale and the Mini Mental Status Exam, respectively. Stride-to-stride variability and gait dynamics were assessed using a portable, ambulatory monitoring system and force-sensitive insoles that were worn during a 2 minute walk on level ground. We observed a strong association between increased fear of falling and increased stride-to-stride variability. In contrast, the degree of fear, as reflected by the ABC, was not associated with fall history or balance performance. New data will try to study more fully the interaction between fear of falling and disturbed gait dynamics and to determine which is the chicken and which is the egg.
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