Does fear of falling relate to low physical function in frail elderly persons?: associations of fear of falling, balance, and gait.

Falls are a major public health problem for older people. Recent research suggests that fear of falling may be a more pervasive and serious problem than falls among the elderly. The present study was conducted to determine whether frail elderly persons with fear of falling have lower physical function. A total of 47 subjects (aged 73 to 95) were recruited from a geriatric health services facility in Osaka. Physical function including balance, mobility, and muscular strength were measured using the following tests: Timed up & go test (TUG), functional reach test, single limb stance with eyes open, ten-meter walk, and knee extensor strength. Twenty-nine subjects (62%) had fear of falling and 18 (38%) had no fear of falling. There was no significant difference in age, sex, or the proportion using assistive devices. Results from the statistical tests showed that there were no differences in physical function, except in the functional reach test. The ratio of TUG to 10 m walk was used to determine the association between balance and mobility. In frail elderly persons with fear of falling and in those without fear of falling, the means of the ratios were 1.20 (SD=0.27) and 1.03 (SD=0.16), respectively. The ratios for frail elderly persons with fear of falling were higher (p=0.024) than the frail elderly without fear of falling. Our study suggests that even if frail elderly individuals walk slowly, they are not afraid of falling if there is a feasible balance function. We conclude that, in low-functioning frail elderly, fear of falling is associated with a combination of balance function and gait speed.