Jane A. Painter, Leslie Allison, Puneet Dhingra, Justin Daughtery, Kira Cogdill, Leonard G. Trujillo; Fear of Falling and Its Relationship With Anxiety, Depression, and Activity Engagement Among Community-Dwelling Older Adults. Am J Occup Ther 2012;66(2):169–176. https://doi.org/10.5014/ajot.2012.002535
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© 2020 American Occupational Therapy Association
OBJECTIVE. This study examined (1) the relationship of fear of falling to depression, anxiety, activity level, and activity restriction and (2) whether depression or anxiety predicted fear of falling, activity level, activity restriction, or changes in activity level.
METHOD. We administered the Survey of Activities and Fear of Falling in the Elderly; the Geriatric Depression Scale–30; and the Hamilton Anxiety Scale, IVR Version, during a one-time visit to 99 community-dwelling adults ≥55 yr old.
RESULTS. We found significant relationships between (1) fear of falling and depression, anxiety, and activity level; (2) depression and anxiety; and (3) activity restriction and depression. Activity level was negatively correlated with activity restriction, fear of falling, depression, and anxiety. Anxiety predicted both fear of falling and activity level. Both anxiety and depression predicted activity restriction because of fear of falling and for other reasons.
CONCLUSION. Occupational therapy practitioners should consider screening their older adult clientele for fear of falling, anxiety, and depression because these states may lead to fall risk and activity restriction.
SAFE A: Do you currently do the activity? (yes or no)
SAFE B: If you do the activity, to what degree are you worried you might fall? (0 = not at all worried, 1 = a little worried, 2 = somewhat worried, and 3 = very worried)
SAFE C: If you don’t do the activity, do you not do it because you are worried you might fall? (0 = not at all worried, 1 = a little worried, 2 = somewhat worried, and 3 = very worried)
SAFE D: If you do not do the activity because of worry, are there also other reasons you do not do it? (if yes, specify reason)
SAFE E: If you are not worried, what are the reasons you do not do the activity? (specify)
SAFE F: Compared with 5 yr ago, would you say you do the activity 1 = more than you used to, 2 = about the same, or 3 = less than you used to?
A person can develop a fear of falling whether or not a fall has occurred.
Anxiety has been found to cause a fear of falling.
Fear of falling can lead to increased fall risk, decreased motivation, and decreased perceptions of capabilities, all of which can then lead to self-imposed activity restriction.
Occupational therapy practitioners should assess for fear of falling and anxiety for older adults who display anxiety and decreased motivation to perform functional activities.
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