Can Attitude Increase The Elderly’s Chances of Injury?

In Seniors, ‘Fear of Falling’ Risky in Itself

Regardless of actual risk, the anxiety made them more likely to tumble, study shows

“Older people who have a fear of falling are at increased risk for future falls, regardless of their actual risk of tumbling, a new study finds.”  U.S. News.

There’s a temptation amongst people who write for the general public to over simplify very complex scientific studies in order to come up with an eye-catching headline.  Very often times it’s a gross oversimplification that makes the study’s author want to punch a journalist.

It’s very easy to mix up causation with correlation.  In a study below a group of elderly folks were assessed for their risk of falling.  The majority of people who were tested agreed with the assessment.  Those judged to be very likely to fall agreed as did those judged to be unlikely to fall.  But on either end of the spectrum there were people who believed just the opposite of the assessments conclusion.

It seems that believing that you are very likely to fall increases your likelihood to have a fall accident, even though her physical assessment says that you aren’t at high-risk. The converse is true.  Elderly people, who were assessed as at risk of all related accidents but believed that they were not likely to fall had a lower than expected rate of falling accidents.

But can you honestly make that conclusion? What if the diagnostic test failed to uncover something that would make a person more likely were least likely to fall?

If you read the abstract of the study you’ll see that the authors are much more cautious in pronouncing it clear causal connection.

Objectives To gain an understanding of elderly people’s fear of falling by exploring the prevalence and determinants of perceived and physiological fall risk and to understand the role of disparities in perceived and physiological risk in the cause of falls.

Conclusion Many elderly people underestimated or overestimated their risk of falling. Such disparities between perceived and physiological fall risk were primarily associated with psychological measures and strongly influenced the probability of falling. Measures of both physiological and perceived fall risk should be included in fall risk assessments to allow tailoring of interventions for preventing falls in elderly people.  BMJ.com

It does appear that people who are afraid of falling seem to fall more often than the diagnosis would have predicted. That’s about all you can say.   The paper doesn’t try to prove the reality of self-fulfilling prophecies as related to fall accidents.

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