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fear of falling

Etiology: - dizziness - Parkinson's disease - stroke - hospitalization, deconditioning - visual impairment is associated with higher prevalence of fear of falling - not associated with activity limitation due to fear of falling [13] Complications: - risk factor for falls in the elderly [7,11] Management: - multicomponent intervention consisting of strength & balance exercises reduces fear of falling over 24 months (RR=0.6-0.7) [9] - integrated cognitive-behavioral therapy & exercise may alleviate fear of falling [2] - benefits may be sustained for > 6 months [12] - Tai Chi with cognitive-behavioral intervention (CBI) reduces fear of falling & improves sense of well-being

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falls in the elderly

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fear

References

  1. Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  2. Wetherell JL, Bower ES, Johnson K et al. Integrated exposure therapy and exercise reduces fear of falling and avoidance in older adults: a randomized pilot study. Am J Geriatr Psychiatry. 2018;26(8):849-859 https://www.ajgponline.org/article/S1064-7481(18)30295-1/fulltext
  3. Liu TW, Ng GYF, Ng SS Effectiveness of a combination of cognitive behavioral therapy and task-oriented balance training in reducing the fear of falling in patients with chronic stroke: study protocol for a randomized controlled trial. Trials. 2018 Mar 7;19(1):168 PMID: 29514677 PMCID: PMC5842580 Free PMC article
  4. Chua CHM, Jiang Y, Lim S, Wu VX, Wang W. Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: A systematic review and meta-analysis. J Adv Nurs. 2019 Dec;75(12):3299-3315 PMID: 31287182
  5. Hagovska M, Olekszyova Z. Impact of the combination of cognitive and balance training on gait, fear and risk of falling and quality of life in seniors with mild cognitive impairment. Geriatr Gerontol Int. 2016 Sep;16(9):1043-50 PMID: 26338465
  6. Liu YW, Tsui CM A randomized trial comparing Tai Chi with and without cognitive-behavioral intervention (CBI) to reduce fear of falling in community-dwelling elderly people. Arch Gerontol Geriatr. 2014 Sep-Oct;59(2):317-25 PMID: 24953768
  7. Delbaere K et al. Determinants of disparities between perceived and physiological risk of falling among elderly people: Cohort study. BMJ 2010 Aug 20; 341:c4165. http://www.bmj.com/content/341/bmj.c4165.full PMID: 20724399
  8. Austin N, Devine A, Dick I, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007 Oct;55(10):1598-603. PMID: 17908062 - Visschedijk J, Achterberg W, Van Balen R, Hertogh C. Fear of falling after hip fracture: a systematic review of measurement instruments, prevalence, interventions, and related factors. J Am Geriatr Soc. 2010 Sep;58(9):1739-48. Review. PMID: 20863333
  9. Hentschke C, Halle M, Geilhof B et al 24-Months Cluster-Randomized Intervention Trial of a Targeted Fall Prevention Program in a Primary Care Setting. Gen Intern Med 2021. July 8. PMID: 34240282 https://link.springer.com/article/10.1007/s11606-021-06944-w
  10. Austin N, Devine A, Dick I, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007 Oct;55(10):1598-603. PMID: 17908062 - Visschedijk J, Achterberg W, Van Balen R, Hertogh C. Fear of falling after hip fracture: a systematic review of measurement instruments, prevalence, interventions, and related factors. J Am Geriatr Soc. 2010 Sep;58(9):1739-48. Review. PMID: 20863333
  11. Asai T, Oshima K, Fukumoto Y et al The association between fear of falling and occurrence of falls: a one-year cohort study. BMC Geriatrics, 2022, May 5;22(1):393 PMID: 35509040 PMCID: PMC9069732 Free PMC article https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-03018-2
  12. Lenouvel E, Ullrich P, Siemens W et al. Cognitive behavioural therapy (CBT) with and without exercise to reduce fear of falling in older people living in the community. Cochrane Database Syst Rev. 2023 Nov 15;11(11):CD014666 PMID: 37965937 PMCID: PMC10646947 (available on 2024-11-15)
  13. Jin H, Zhou Y, Stagg BC, Ehrlich JR. Association between vision impairment and increased prevalence of falls in older US adults. J Am Geriatr Soc. 2024 May;72(5):1373-1383. PMID: 38514075