Fear of falling and its relationship to depression and anxiety in older adults living in the community and in extended care facilities in Australia

One of the most common psychological costs of falls in older adults is the development of a fear of falling, which can then result in an increased risk of future falls. The purpose of this research was to examine the relationships between fear of falling and two of the most common psychological disorders in later life; depression and anxiety. To extend on previous research, study one aimed to investigate the relationships between fear of falling, depression and anxiety in an Australian community-dwelling population using quantitative analysis. Due to the limited number of studies examining fear of falling in the extended care population, study two was an exploratory investigation of the above relationships in this population using both quantitative and qualitative analysis. A total of 80 community-dwelling older adults and 47 extended care older adults completed the questionnaires. A further 12 older adults participated in the interviews. The findings, overall, extended on previous research, where anxiety was consistently associated with fear of falling constructs in both the community and extended care populations. In contrast, associations between fear or falling and depression were variable within and across studies, depending on the fear of falling measurement that was used. In addition, an important finding from the qualitative analysis revealed that older adults may view their feelings as a “concern” rather than a “fear”, supporting recent suggestions to revise how fear of falling is described. The clinical implications were discussed in terms of the importance for clinicians who work with older adults with mood disorders to screen for fear of falling and address this in clinical interventions. Furthermore, results suggest that assessment should include both an interview and questionnaires in order to capture all fall-related psychological concerns.