Having a fear of falling can lead to actual falls among older people, irrespective of their real physical risk of falling, new research finds.

The study, lead by Prof Stephen Lord from Neuroscience Research Australia, assessed 500 Australians aged 70 – 90 years and found that a large number of elderly people are overly fearful of falling.

“Fear leads to a downward spiral for older people,” says Prof Lord. ​“When older people fear falling, they become less active and lose strength and balance. This inevitably means they begin to fall more often, which can lead to a loss of independence and need for care in a nursing home.”

Fear of falling is common in older people and is associated with poor balance, as well as anxiety and depression.

The study found that while most older people have an accurate perception of their fall risk, up to one third of elderly people either underestimate or overestimate their risk of falls.

Those people in the study who were overly anxious about falling also had symptoms of depression and neurotic personality traits. These psychological characteristics were just as important a contribution to falling as physical incapacity, says Prof Lord.

In contrast, those people who were overly confident, even though they had a high actual risk, were actually protected against falling.

“We think that having a positive outlook helps people keep active, which protects against falls,” says Prof Lord.

Prof Lord says that older people can reduce their risk of falls by exercising at least twice a week for an hour each time and improving their balance through Tai Chi or other standing exercises that require coordination, agility and quick stepping.

However, staying positive is essential to preventing falls, he says.

Prof Lord says their next study will look at preventing fear of falling through cognitive behavioral therapy, combined with exercises to improve balance.

The study was published in the British Medical Journal (BMJ).