AGING
September 4, 2010

Mind Over Matter

Seniors who worry about falling actually fall more than those who don't, even when their risk of falling is the same.

We’ve all heard the term "self-fulfilling prophecy" to describe the idea that when we expect something to happen, sooner or later it will. In this vein, new research finds that the risk of falling in otherwise healthy seniors actually rises in relation to how worried they are about falling.

Some seniors were labeled as "anxious," meaning that while their physical risk of falling was low, they perceived it as high. And this group of individuals actually fell more than people in the "stoic" group, who had a higher physical risk of falling but perceived it as low.

The researchers followed 500 healthy seniors, aged 70-90. They examined the participants medically and psychologically, which allowed them to determine each person’s actual, physiological risk of falling as well as their perceived risk of falling. They then tracked how many people experienced falls within the next year.

The team, led by Stephen Lord at the Falls and Balance Research Group in Wales, found that some people were accurate at rating their own fall risk, whether it was low or high, and this correlated well with how often they actually fell in that one-year period. But other participants were not very accurate in their risk assessment. For example, some seniors were labeled as "anxious," meaning that while their physical risk of falling was low, they perceived it as high. And this group of individuals actually fell more than people in the "stoic" group, who had a higher physical risk of falling but perceived it as low. In fact, Lord and his team found that one’s perceived risk of falling was just as good a predictor of falling as one’s actual risk of falling.

Lord and his colleagues say that perceived risk of falling should perhaps be factored in to the equation when clinicians assess a senior’s risk of future falls. "The inclusion of psychological and cognitive factors should improve the accuracy of prediction of falls", they write. Doing this might also help doctors determine effective fall prevention treatments, like cognitive behavior therapy and specific exercises for seniors whose perceived risk is disproportionate to their actual risk.

It’s easy to worry about something until it comes true, and this study illustrates that concept beautifully. Of course, the tricky part is learning how not to boost our chances at misfortune with excessive worry, but with the right methods (mindfulness meditation, for example), it can be done.

The study was published in the August 20, 2010 issue of BMJ.

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