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Affective Correlates of Fear of Falling in Elderly Persons

Received April 20, 2004; revision received July 27, 2004; accepted July 31, 2004. From the Departments of Psychiatry, University of Toronto and University Health Network, Toronto, Ontario (AJF, GMD); The Departments of Medicine, University of Toronto and University Health Network, Toronto, Ontario (GN); the Geriatrics Program and Research Institute, Toronto Rehabilitation Institute, Toronto, Ontario (AJF,GN); and the Department of Psychiatry, Laval University and Robert-Giffard Hospital, Quebec City, Quebec (NG). Send correspondence and reprint requests to Dr. Alastair Flint, Toronto General Hospital, 200 Elizabeth Street, 8 Eaton North, Room 238, Toronto, Ontario, M5G 2C4, Canada. e-mail: alastair.flint{at}uhn.on.ca
© 2005 American Association for Geriatric Psychiatry

Objective: Fear of falling is common in older people, occurring on average in 50% of those who have fallen in the previous year. Little is known about the psychological correlates of fear of falling. The purpose of this study was to determine whether clinically significant depression and anxiety were independently associated with fear of falling. Methods: This was a cross-sectional study of 105 persons age 60 years, admitted to medical or orthopedic wards, who had fallen at least once in the previous 12 months. Fear of falling was assessed using two different constructs: 1) intensity of fear; and 2) self-efficacy. Depressive and anxiety disorders were assessed with the Structured Clinical Interview for DSM-IV. Depression and anxiety severity were assessed with the Hospital Anxiety and Depression Scale. Demographic, physical, functional, and social variables previously found to be associated with fear of falling were also measured. Logistic-regression and multiple-regression analyses were used to examine the independent association of affective variables with fear of falling. Results: Depressive disorders, anxiety disorders, depression severity, and anxiety severity had significant independent associations with both constructs of fear of falling. Of all the variables that were measured, depressive disorders and depression severity had the strongest associations with fear of falling. Conclusion: Affective variables had a stronger association with fear of falling than non-affective variables in a hospital-based group of subjects. Further research is needed to determine whether similar findings occur in a community-based sample of older people.

Key Words: Anxiety Disorders • Depression • Comorbidity

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