Fear of Falling Avoidance Behavior, but Not Fall History, Is Associated with Balance and Dynamic Gait Performance in Community-Dwelling Older Adults: A Cross-Sectional Study

Abstract

Purpose: The purpose of this study was to determine relationships among balance confidence, fear of falling (FoF) avoidance behaviour, and high-level balance performance in community-dwelling older adults. Method: Eighty-nine participants [76 ± 7 (mean ± standard deviation) years, 54 females] completed the Activities-specific Balance Confidence Scale, Fear of Falling Avoidance Behavior Questionnaire, Functional Gait Assessment (FGA), Community Balance and Mobility Scale (CB&M), and falls experienced in the past 12 months for this cross-sectional study. Results: Outcome measure (OM) scores did not differ between people who reported a fall and those without a fall. Correlations between all OMs varied from 0.52 to 0.88. FoF avoidance behaviour, but not fall history, was associated with lower scores on all measures. There were no floor or ceiling effects for the performance-based OMs. Conclusion: FoF avoidance behaviour did not differ between community-dwelling older adults with and without a previous fall. Participants who reported FoF avoidance behaviour had poorer balance performance, suggesting clinicians should assess high-level balance performance in older adults who exhibit FoF activity avoidance. Patient-reported OMs may identify older adults who need an assessment of dynamic balance and gait. The CB&M and FGA are appropriate to assess high-level balance in older adults.