[Cautious gait and fear of falling in the elderly]

Falls are common in the elderly, and fear of falling is widely prevalent. This review emphasizes some of the defensive adaptations that occur in relation to concern about balance, and the phenomenon of cautious gait and fear of falling. Fear of falling affects those who never fall as well as those who do. Anxiety and fear can profoundly influence motor performance, resulting in a timid gait. However, fear of falling can take a more pathological turn and negate its survival value. Comorbid conditions associated with fear of falling appear to be similar to those responsible for falls. A fall evaluation should always include an assessment of fear of falling. All these conditions should be viewed as reversible causes of gait failure in the elderly. A number of interventions can help alleviate fear of falling and improve confidence.