ORLANDO – Cognitive-behavioral therapy can significantly reduce seniors' fear of falling and the avoidance of activity that accompanies it, according to the preliminary results of a Dutch study.
CBT may also improve depression and quality of life; however, this data remains to be analyzed, reported Rixt Zijlstra, a Ph.D. candidate at the University of Maastricht, the Netherlands.
Previous work by her group has shown that up to 52% of Dutch adults aged 70 years and older have a fear of falling, regardless of whether they have actually fallen in the past, she said at the annual meeting of the Gerontological Society of America.
Her study randomized 540 community-living adults aged 70 years or older to CBT or no therapy (control group). All participants felt at least some fear of falling and avoided certain activities as a result of that fear. The CBT was designed to challenge the fear through the exploration and management of concerns about falling, the recognition of risks, and instruction in physical exercises and assertiveness designed to optimize fall prevention.
CBT was delivered in 8 weekly sessions of 2 hours each, followed by one booster session at 6 months. Groups included about 10 participants each and were run by nurses trained in geriatric medicine.
One year after the start of the CBT, fear of falling was reported by 25% of the intervention group, compared with 43% of the control group, a significant difference. Avoidance of activities was reported by 25% of the intervention group and by 35% of the control group, she said. The intervention group also reported better perceived control and more daily activity than did the control group.
About 88% of the intervention group said they behaved more safely as a result of the CBT, 80% said they had more confidence, and 75% reported an increase in their physical activity. Secondary outcomes of general health, life satisfaction, physical functioning, anxiety, depression, social support, feelings of loneliness, and falls–and their clinical significance–have not yet been analyzed.