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

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 > or = 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.