The elderly and fear of falling: Features and applications of cognitive-behavioral therapy

Due to population aging, fear of falling has become a common and serious health challenge. It is characterized by excessive anxiety about the inability to maintain one’s balance. Fear of falling is associated with restricted physical activity, physical deconditioning, an increased risk of falling, and compromised quality of life. To date, no interventions have been found to reliably prevent this psychological disturbance and its associated functional impairments. However, exercise therapy and cognitive-behavioral therapy (CBT) can offer significant improvements, as evidenced by previous empirical findings. We first review the literature on fear of falling, including its characteristics and emerging treatment approaches, and then identify the potential mechanisms by which such interventions exert their treatment effects. We also outline methods of delivering CBT for fear of falling and associated avoidance behavior and make recommendations for future research.