Influence of Concern About Falls on Threat-Induced Emotional and Postural Responses in Older Adults

This study aimed to clarify whether concern about falls contributes to inducing emotional and postural responses when threatened in older adults while standing on an elevated platform. Seventy-four older adults (mean age: 78.8 ± 5.8 years, 65 female) were exposed to fear while standing on the floor and on an elevated 0.6 m surface. We examined the changes in self-reported fear of falling, physiological measures, postural sway, and muscle activity. The older adults were classified as having lower (n = 11), moderate (n = 24), and higher concern about falls (n = 39), based on the Falls Efficacy Scale International. All groups significantly shifted their posture backwards, and increased tibialis anterior activity and co-contractive activity with the soleus was noted when standing at a height, which is a rational behavior to decrease the risk of falling and maintain safety. The participants with higher and moderate concern about falls had significantly increased self-reported fear and pulse rate on the elevated surface compared to the floor condition. Older adults with greater concern about falling also increased their sway velocity in the elevated condition. These findings reveal an underlying relationship between concern about falls and emotional and postural responses in fear-inducing situations.