Elderly Likely to Under- or Overestimate Risk of Falling

Disparity between perceived, actual risk appears to influence probability of falling

FRIDAY, Aug. 20 (HealthDay News) -- Elderly individuals often underestimate or overestimate their risk of falling, and the disparities between their perceived and physiological risk are associated with psychological measures and have a strong influence on the likelihood of actually falling, according to a study published online Aug. 19 in BMJ.

Kim Delbaere, Ph.D., of the University of New South Wales in Sydney, Australia, and colleagues performed medical, physiological, and neuropsychological assessments of 500 men and women, aged 70 to 90 years, and estimated physiological and perceived fall risks using standardized scoring scales. The researchers compared the disparity between each subject's perceived and physiological risk of falling and followed the subjects for one year.

Based on the physiological/perceived fall risk comparisons, the subjects fell into four groups: vigorous (low physiological risk, low perceived risk), aware (high physiological risk, high perceived risk), anxious (low physiological risk, high perceived risk), and stoic (high physiological risk, low perceived risk). Overall, the researchers found that 43 percent of the subjects reported falls during the study period. Fall rates for groups were as follows: vigorous, 20 percent; stoic, 34 percent; anxious, 39 percent; and aware, 41 percent. For the vigorous and aware groups, perceived risk was congruent with physiological risk. The anxious subjects tended to have depressive symptoms, neurotic traits, and diminished executive functioning, while the stoic group were physically active and had a positive outlook, and their low perceived risk was protective against 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," the authors write.

The physiological profile assessment (NeuRA FallScreen) used in the study is sold commercially through Neuroscience Research Australia.

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