91 Individuals Aged 65-69 Years Have Poorer Postural Control Related to Fear of Falling than Individuals Aged 70-74 Years. (20th December 2019) - Mat, Sumaiyah
Abstract: Background: Fear of falling (FoF) is common in older people with a history of falls and increases the risk of future falls. It is postulated that individuals with FoF may lose the balance control in response to threatening situations due to psycho-emotional responses to a previous event. Little is known of how FoF influences postural control in older people. Aim: To compare the influence of age in the association between FoF and postural control among older persons Methods: A case-control study involving individuals aged ≥65 years with ≥2 falls or one injurious fall over 12 months with volunteers aged ≥65 years with no falls in the past year. Postural sway was quantified by using a long force-plate balance platform (Balancemaster, NeuroCom, USA). Fear of falling was assessed using the short Falls Efficacy Scale-International questionnaire. Result: Of 102 participants recruited in this study, 33 (32.4%) were aged 65-69y, 36 (35.3%) aged 70-74y, and 33 (32.4%) age≥ 75y. There was no significant difference in FoF across the groups. The oldest age group had poorer postural control. Fear of falling in the youngest old group was associated with poorer standing balance in 'eyes closed, firm surface' conditions (p-value=0.012), forward maximal excursion (p-value=0.007), forward end point (p-value=0.001), forward movement velocity (p-value=0.008) and forward directional control (p-value <0.001). The associations remained significant even after adjustment of history of falls, body mass index and comorbidities. Conclusion: The influence of FoF on postural control is age dependent with posturography measurements only significantly associated with FoF within the 65-69y age group, but not the 70-74y or ≥ 75y age groups. Psychological interventions for fall prevention may therefore be more appropriately targeted according to age groups, rather than treating all over 65s as a homogenous group. This approach should be evaluated in future studies.