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Fear of falling syndrome: a fall leads to a fear of falling which leads to cautious gait increasing the risk of falling (a viscous cycle)

What is fear of falling?

Fear of falling is more complicated than it sounds. It is a person’s belief in their own ability to perform a task safely, without losing balance or falling. However, it is even more than just having the confidence to do something. A fear of falling involves real anxiety and can result in physical sensations associated with fear, such as nausea and palpitations.

Often, fear of falling appears after a fall. But it can also affect people who have not had any falls, usually those with dizziness, difficulty walking, depression or balance problems.

Why is it important?

Fear of falling is important as it can lead to avoidance of activities which in turn causes a person to move less and therefore become less fit - losing strength, mobility and balance, putting the individual at further risk of falls. This sets off a vicious cycle of falling and fear, as is illustrated above.

Larger version of the diagram shown at the top of the page.

It can affect people in different ways. Some people may avoid leaving the house altogether, out of a fear of falling outdoors. Whereas some people may only experience their fear in very specific situations. For example, someone who fell while taking their rubbish out on a windy day, may only experience their fear of falling when taking the rubbish out, or on days when it is windy.

Can we treat it?

Yes. Treatment is often delivered by a physiotherapist. The aim is to stop the cycle by increasing activity, improving gait and increasing confidence with balance.

A full falls assessment should also take place to address any other risk factors, preventing further falls and breaking the cycle with a different tactic.

Another emerging treatment is cognitive-behavioural therapy. We will explore some of the recent research around this therapy in Week 4.

Measuring your fear of falling

Back in Week 1, we asked you to complete the fear of falling survey. On the next step we are going to view and discuss the results. If you have not yet done the survey and would like to, you can complete it by revisiting Step 1.20. Otherwise, continue to the next step where we can see the survey results.

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This article is from the free online course:

Ageing Well: Why Older People Fall

Newcastle University

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