A Longitudinal Investigation of Fear of Falling, Fear of Pain, and Activity Avoidance in Community-Dwelling Older Adults

Objective: The primary purpose of this study was to examine the role of fear of falling, fear of pain, and associated activity avoidance in the prediction of pain and falls. Method: A 6-month longitudinal study of older community-dwelling adults. Results: The authors found that fear of falling is a better predictor of falls than is activity avoidance. Moreover, fear of pain did not predict future pain-related avoidance or future pain in the sample of seniors. Discussion: The findings confirm the ability of fear of falling to predict falls but challenge preexisting models developed to account for the relationship between falls and fear. The findings also suggest limits on the generalizability of fear—avoidance models of pain. The authors conclude by suggesting mechanisms that could account for the relationship of fears with falls and pain. Unlike previous conceptualizations, these mechanisms do not rely on activity avoidance as an explanation.