Falls-related psychological concerns in the community-dwelling older adult population.

Section A explores the theoretical underpinnings of the four concepts included within the umbrella term ‘falls-related psychological concerns.’ These are fear of falling, falls-related self-efficacy (FSe), balance confidence and outcome expectancy. It goes on to examine the empirical literature on psychological factors associated with falls-related psychological concerns, and the limited literature exploring how the psychological factors mediate between falls-related psychological concerns and falls. A model of falls-risk is presented to consider these mediating roles. The clinical and research implications of the review findings are considered.
Section B reports an empirical study, which explored cognitive coping responses employed by community-dwelling older people to manage their falls-related psychological concerns. It explored if these coping responses mediate the relationship between falls-related psychological concerns and falls. Correlation and regression analyses were employed to explore the relationships between these variables. Robust analysis was conducted using bootstrapping, and a bootstrapped mediation analysis, based on Baron and Kenny’s (1986) model was employed. The study concluded that FSe and falls were strongly associated, and ‘self-controlling’ coping was found to be a partial mediator of this relationship. Study limitations, theoretical and clinical implications, and suggestions for further research are provided.