Fear of falling can increase the risk of actually falling
It is estimated that one in three people over 85 living at home fall once a year. Most of the time, the outcome is mild: only around five to ten percent of falls result in serious injuries. However, many older people are afraid of falling, breaking something and becoming in need of care. This worry can become so excessive that sufferers limit their daily activities.
This creates a vicious circle of insecurity and physical weakness. This increases the likelihood of actually falling. A team from the Cochrane Network has investigated whether cognitive behavioral therapy can help break the vicious circle and reduce fear of falling.
Cognitive behavioral therapy: easily explained
Cognitive behavioral therapy is a psychotherapeutic procedure. The aim of this therapy is to alleviate mental illnesses such as anxiety disorders by changing the thoughts, feelings, physical reactions and behavior of those affected. The idea is to unlearn behavior learned through conversations and exercises. You can read about what distinguishes cognitive behavioral therapy from other psychotherapy procedures in our article on different forms of therapy.
Treatment measures evaluated for 2,300 seniors
Researchers from Germany, Switzerland and the Netherlands analyzed twelve studies with a total of more than 2,300 independently living 73 to 83 year olds. They received different treatment measures over a period of eight to 48 weeks. The behavioral therapy measures mostly took place in groups, sometimes with additional exercise training.
Improvement observed after therapy
The result is hopeful: those affected felt confident enough to do more activities again after the therapy. Depression symptoms also subsided. The improvements appeared to last for the first six months after treatment and beyond. The researchers therefore conclude: Cognitive behavioral therapy is likely to reduce fear of falling in older people who live independently.
Even small improvements count
It remained unclear whether fewer falls occurred after therapy. It is also difficult to estimate whether the positive effects will be clearly noticeable in the everyday lives of those affected. But given the physical, psychological and social consequences of fear of falling, even a slight improvement could be important, say the researchers.
Tipp: Those interested should contact a psychotherapist. If you are diagnosed with an anxiety disorder, your health insurance companies will cover the costs. Psychotherapy can also help with other mental illnesses such as depression in old age.
Reduce the risk of falls with concrete measures
In order to prevent falls in old age, it is important to identify possible causes. Typical tripping hazards include doorsteps, a slippery bathtub or loose-fitting slippers. Health problems such as dizziness, dementia, diabetes and a number of medications such as antihypertensives can also increase the risk of falls.
These measures can help:
Remove smaller tripping hazards such as carpet edges and cables Wear shoes – including slippers – with a firm grip Adjust the apartment, for example remove door thresholds or install grab bars in the bathroom (for more see Preventing falls in old age) Use walking aids such as walking sticks or a walker If your vision changes, use glasses at the optician Have it adjusted Talk to your doctor about the medications you take regularly Use exercise courses to prevent falls. Some health insurance companies offer them free of charge, others contribute to the costs.
Tipp: We give lots of advice on designing your bathroom, kitchen, bedroom and living room in our article on barrier-free living.