Psychological Factors Associated With Fear of Falling Avoidance Behavior in Parkinson's Disease

Abstract

<h3>Research Objectives</h3> To examine the relationship between psychological factors (catastrophizing, depression, and anxiety) and fear of falling avoidance behavior (FFAB) among individuals with Parkinson's disease (PD). <h3>Design</h3> A secondary analysis of previously published cross-sectional data. Factors associated with FFAB were examined using hierarchical multiple regression analysis. <h3>Setting</h3> University research lab. <h3>Participants</h3> A convenience sample of 59 participants diagnosed with PD were recruited from local PD support groups (Mean age = 72 years old ± 9.4 years, Men = 49, Women = 14). Exclusion criteria included cognitive impairment (defined as a score of < 24 on the Mini-Mental State Exam) and non-PD-related comorbidities that significantly impaired balance. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> FFAB was measured by the Fear of Falling Avoidance Behavior Questionnaire (FFABQ), disease severity by the Movement Disorder Society – Unified PD Rating Scale, catastrophizing by the Consequences of Falling Questionnaire (CoF), depression by the Beck Depression Inventory, and anxiety by the Zung Self-Rating Anxiety Scale. <h3>Results</h3> Disease severity and catastrophizing explained approximately 48.2% of the variance in FFABQ scores. Catastrophizing was the only significant psychological variable (p < .001). The damage to identity subscale of the CoF was significant in the final model (p < .001). <h3>Conclusions</h3> Catastrophizing about the consequences of falls explained the largest portion of variability in FFAB after controlling for disease severity and had a stronger association with FFAB than general anxiety or depression. Moreover, catastrophizing about the immediate and social consequences of falling, rather than the enduring physical or functional consequences, may play a prominent role in FFAB and may be a potential treatment target for mitigating maladaptive FFAB. <h3>Author(s) Disclosures</h3> The authors declare no conflicts of interest.