Differential impacts of psychological and social factors on fear of falling amongst community-dwelling older adults

OBJECTIVES: This cross-sectional study explored the differential impact of psychological and social factors on fear of falling (FoF) beyond the impact of biological factors. The authors hypothesized that self-reported depressive symptoms, income, and living arrangement would have a greater impact on FoF than a model including biological measures of current level of physical function controlling for, age, sex, race, and past falls history (Biological Model). METHODS: Self-reported demographics, perceived health, and depression were collected from 361 community-dwelling older adults aged 55+ during balance assessments at twelve community-based centers. The primary outcome measure of FoF was the Activities Balance Confidence (ABC) scale score. Two linear regression models compared the differential impact of biological versus psychological and social factors on ABC scores. RESULTS: The addition of psychological and social variables was significantly impactful to ABC scores beyond the biological model (LR X² = 31.92, p < 0.001). Comfortable gait speed and self-reported depression scores were the most significant predictors of ABC score (t = 4.33 and t = -4.19 respectively). CONCLUSIONS: Findings support a multifactorial etiology for FoF among older adults. Rehabilitation professionals working with individuals experiencing FoF should incorporate psychological assessments alongside measures of current function to ensure a comprehensive examination.