Fear of Falling Avoidance Behavior in Parkinson’s Disease: Most Frequently Avoided Activities

Abstract

Background: Fear of falling avoidance behavior (FFAB) is common in Parkinson’s disease (PD). Objectives: The objectives of the study are to determine what activities are most avoided due to FFAB among people with PD and whether any associations exist with demographic factors or fall history. Method: Cross-sectional analysis of 174 individuals with PD using the Modified FFAB Questionnaire. Results: Walking in dimly lit, unfamiliar places, and different surfaces, lifting and carrying objects, walking in crowded places, recreational/leisure activities, and going up/downstairs were most avoided. Fallers reported more FFAB ( ps < .029). FFAB for certain activities was associated with increased or decreased odds of falling. Conclusion: Individuals with PD avoid walking in compromised situations and engaging in recreational/leisure activities due to FFAB. While excessive FFAB may increase the odds of falling, protective forms may be associated with decreased odds. Targeting FFAB among individuals with PD may increase safe participation in meaningful occupations in the home and community.

Psychological Factors Associated With Fear of Falling Avoidance Behavior in Parkinson’s Disease: The Role of Depression, Anxiety, and Catastrophizing

“…18 Because FFAB has been reported among individuals without a history of falls and in mild stages of PD, further investigation is warranted into the psychological aspects of FFAB. 5,9,19 From a clinical perspective, healthcare practitioners may identify and address psychological factors in the early stages of PD, decreasing FFAB and its associated downstream consequences. Additionally, addressing FFAB may decrease psychological concerns, such as depression, anxiety, and catastrophizing.…”

“…18 Because FFAB has been reported among individuals without a history of falls and in mild stages of PD, further investigation is warranted into the psychological aspects of FFAB. 5,9,19…”

Landing wise program: feasibility study protocol for Parkinson’s disease

“…Falls are common among people with PD ( 5 , 6 ), and, notably, the fall rate in this population is often higher than that observed in older adults without PD ( 5 , 7 ). Consequently, they can experience fearful anticipation of falls, developing a fear of falling (FOF) ( 8 , 9 ). The FOF can ultimately reduce balance performance and limit the person’s activity levels ( 8 , 10 ), compromising one’s quality of life ( 11 ).…”

“…The FOF can ultimately reduce balance performance and limit the person’s activity levels ( 8 , 10 ), compromising one’s quality of life ( 11 ). Fall prevention programs mainly targeted intrinsic (e.g., muscle weakness, balance problem) or extrinsic (e.g., environmental hazards) fall risk factors ( 9 , 12 ). Despite the benefits of these programs, it is crucial to highlight that participants within these programs are still at risk of falling ( 13 ).…”