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Age and Ageing Advance Access originally published online on May 18, 2009
Age and Ageing 2009 38(4):435-440; doi:10.1093/ageing/afp066
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The influence of fear of falling on gait and balance in older people

Miriam F. Reelick1, Marianne B. van Iersel1, Roy P. C. Kessels1,2,3 and Marcel G. M. Olde Rikkert1

1 Department of Geriatrics, Radboud University Nijmegen Medical Centre, The Netherlands
2 Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands
3 Department of Medical Psychology, Radboud University Nijmegen Medical Centre, The Netherlands

Address correspondence to: M. F. Reelick. Tel: (+31) 24 3668296; Fax: (+31) 24 3617408. Email: M.Reelick{at}ger.umcn.nl

Background: fear of falling (FoF) has great impact on functioning and quality of life of older people, but its effects on gait and balance are largely unknown.

Methods: we examined FoF in 100 participants aged ≥75 years, using the Activities-specific Balance Confidence scale. Participants with a mean score <67% were assigned to the FoF group. We quantified gait and balance during walking at the preferred velocity with and without a cognitive dual task (arithmetic task and verbal fluency), using an electronic walkway (Gaitrite®) and a trunk accelerometer (SwayStar®). Primary outcome measures were gait velocity, stride-length and stride-time variability, as well as mediolateral angular displacement and velocity.

Results: gait velocity was significantly lower (P < 0.05) and stride-length and stride-time variability were significantly higher (P < 0.05) in the FoF group. However, after standardisation for gait velocity, differences became non-significant. Mediolateral angular displacement and velocity were not associated with FoF. We found no difference between the FoF and no-FoF group with respect to the dual-task effect on gait and balance variables.

Conclusions: the lower gait velocity in the FoF group may be a useful adaptation to optimise balance, rather than a sign of decreased balance control. The ability to attend to a secondary task during walking is not influenced by FoF.

Keywords: older people, fear of falling, gait, balance, dual task, elderly

Received 8 October 2008; accepted in revised form 13 March 2009.


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