Why should clinical practitioners ask about their patients' concerns about falling?

Area of Science:

• Gerontology
• Public Health
• Clinical Medicine

Background:

• Concerns about falling (CaF) are prevalent among older adults.
• Previous recommendations emphasized regular CaF assessment in falls prevention services.
• CaF can be viewed as a dual-edged sword, influencing fall risk through adaptive or maladaptive behaviors.

Purpose of the Study:

• To expand on recommendations for assessing CaF in older adults.
• To explore the adaptive and maladaptive aspects of CaF in relation to falls risk.
• To highlight CaF as an indicator for clinical engagement and intervention.

Main Methods:

• Review and synthesis of existing literature on CaF and falls risk.
• Conceptual framework development to differentiate adaptive and maladaptive CaF.
• Discussion of clinical implications and intervention strategies.

Main Results:

• High CaF can lead to increased falls risk via hypervigilance or activity restriction (maladaptive).
• CaF can also promote safety-enhancing behavioral modifications (adaptive).
• Maladaptive CaF can manifest as overconfidence in balance, paradoxically increasing risk.

Conclusions:

• High CaF, regardless of adaptive or maladaptive nature, signals a need for clinical attention.
• CaF assessment provides an opportunity for clinicians to engage with older adults about their fall risk.
• Tailored clinical interventions can be developed based on the specific types of concerns disclosed by individuals.