Fear of falls may drain seniors' physical function
By Amy Norton
NEW YORK (Reuters Health) - Older adults who limit their activities out of fear of falling may see their physical function deteriorate more rapidly, a new study suggests.
Researchers found that among 673 Italian adults age 65 or older, those who limited their daily activities over fear of falling were more likely to experience worsening disability over the next three years.
The findings, reported in the Journal of the American Geriatrics Society, suggest that self-imposed limits on daily activities may make some older people vulnerable to a more rapid physical decline.
Overall, the study found, 15 percent of participants said they avoided at least three activities out of concern that they might fall. These included activities such as walking outdoors, shopping and visiting friends and relatives.
Over the next three years, these men and women were more likely to suffer worsening physical limitations, such as problems with bathing, dressing or getting in and out of bed. They also showed a more rapid decline in tests of mobility that were done at the beginning of the study and 3 years later.
In addition, the 60 percent of adults who put more moderate restrictions on themselves -- avoiding one or two common activities -- were more likely to develop problems with more complex daily tasks, like housework, cooking and grocery shopping.
This link between fear of falling and declining physical function remained even when the researchers accounted for study participants' health at the outset.
This suggests that "fear-induced activity restriction," itself contributes to physical decline in older adults, according to the researchers, led by Dr. Nandini Deshpande of the University of Kansas Medical Center in Kansas City.
A lack of physical activity, Deshpande explained, affects not only cardiovascular fitness and muscle strength, but also the general functioning of nerves and muscles. In older adults, these effects could hasten or worsen physical disabilities.
In an earlier study, Deshpande told Reuters Health, she and her colleagues found that a combination of exercise to improve balance, and "cognitive restructuring" to boost older adults' self-confidence and ease depression, might help keep seniors active.
Some other studies have shown that gentler forms of activity -- like Tai chi classes or simple home-based exercises -- can also help older people overcome their fear of falling.
Deshpande said that older adults who are worried about their fall risk should talk to their doctors about ways to make exercise and routine daily activities safer.
SOURCE: Journal of the American Geriatrics Society, April 2008.