Fear-related avoidance of activities, falls and physical frailty. A prospective community-based cohort study

Abstract

fear-related avoidance of activities may have negative effects on physical abilities and may also be predictive for future falls. Avoidance of activities is therefore an important additional psychological variable in the development of physical frailty and falling in community-living elderly.

Characteristics associated with activity restriction induced by fear of falling in community-dwelling elderly

“…The prevalence of activity restriction of 57% of the elders who reported FOF corroborates several studies 6,11,12,29,30 , although lower prevalence were identified in this study 4,9,31,32 . These variations may be due to the use of different questionnaires for measuring activity restriction and to the differences in the characteristics of the evaluated population 29,31 .…”

“…Gait is a necessary ability to perform the activities of daily living. Considering that mobility tasks are frequently restricted on elders 4 , it is possible that the longer time spent to walk certain distance by those who restricted activities due to fear of falling has happened due to the decline of physical capacities associated with physical inactivity and with social isolation 4,6,9 .…”

“…FOF may lead to a reduction or restriction of functional activities [3][4][5][6] and is associated with adverse outcomes such as falls 3,4 , functional decline 5 and depression 7,8 .…”

“…Activity restriction due to fear of falling when present in excessive level, may provide loss of independence for reducing the social interaction, which in turn lead to physical inactivity and reduced quality of life 4,5,7,9 . Activity restriction is a predictor of falls, possibly because of the unchaining decline of muscle function, physical deconditioning, balance and gait desorders 3,10 .…”

“…Individual characteristics may affect or modulate changes in the behavior associated with FOF, which may lead to the development of protection attitudes and caution in relation to falls that allow elders to manage their fear without restricting activities 4,[9][10][11][12] . Deshpandeet al 11 suggest that depression may modulate the factors that affect activity restriction due to fear of falling.…”