- Concerns – or fears – about falling triple the risk of future falls, new research from Neuroscience Research Australia and the World Falls Guidelines working group on concerns about falling has found.
- Falls are the leading cause of injury-related hospitalisations and cost the Australian health system nearly $3 billion annually.
- Assessing concerns about falling and providing targeted support could help reduce the risk of future falls.
Concerns – or "fears" – about falling are a strong predictor of future falls, according to a new international study led by Neuroscience Research Australia (NeuRA).
In Australia, falls are the leading cause of injury-related hospitalisations and are now responsible for 400 hospitalisations every day. The impact of a fall can be life-changing - often resulting in long-term disability, loss of independence, social isolation and a premature move into residential aged care.
The systematic review and meta-analysis were led by NeuRA Senior Research Scientist and Director of Innovation and Translation at the Falls, Balance and Injury Research Centre, Professor Kim Delbarere, in collaboration with the World Falls Guidelines working group on concerns about falling and it confirmed that concerns about falling independently predicts future falls.
"Many older Australians develop concerns about falling, and this concern itself increases their risk of future falls," Prof Delbaere said.
"Our analysis found that older adults with high concerns about falling were significantly more likely to experience a fall. While we already knew having had prior falls was a risk factor for developing concerns about falling, this research found falling can be both a cause and consequence of falls.
"Importantly, this increased risk was observed even after accounting for key physical risk factors such as age, previous falls and balance impairments. This means that concerns about falling are not just a reflection of physical frailty but an independent factor influencing future falls."
The importance of asking about concerns about falling
The review, which analysed 53 studies involving more than 75,000 participants, concluded not only that concerns about falling should be routinely included in fall risk assessments of older adults.
"Concerns about falling are highly prevalent in older adults, affecting nearly 1 in 2 people by age 85. They have been linked to reduced quality of life and independence, poor rehabilitation outcomes and increased risk of frailty, disability and admission to care homes," Prof Delbaere said.
"The first step in prevention is starting the conversation. Many older adults don't talk about their concerns unless asked, yet these concerns are real and can increase their risk of falling. By routinely discussing concerns about falling, healthcare professionals, families and caregivers can help older adults take early action to stay active and independent."
The 2022 World Falls Guidelines recommended assessing concerns about falling and Prof Delbaere said these new findings provide stronger evidence to reinforce that recommendation.
"These findings fill a critical evidence gap and further support the inclusion of concerns about falling in risk assessments in national and international guidelines," Prof Delbaere said.
Addressing concerns about falling and preventing falls
"After identifying concerns about falling, it is important to support people with targeted, multidisciplinary interventions such as exercise, cognitive behavioural therapy and occupational therapy, to help reduce their risk of falls," Prof Delbaere said.
"By identifying concerns about falling and other risk factors early and providing the right interventions, we can help older adults stay active, independent and confident in their mobility, ultimately improving their quality of life.
"Falls are not an inevitable part of ageing - they are preventable. With strong evidence showing up to 30% of falls are preventable, it's time for Australia to invest in a coordinated national strategy and make falls prevention a public health priority, not an afterthought."
The report was published in Age and Ageing and can be read here.
