What do mental health and falls in older adults have in common? A lot more than you may think.

The Fear of Falling

As you age, the fear of falling starts to creep into your thoughts more and more. Why? Because falling could mean injuries that are not only painful but that also make it hard to get around, do everyday activities, or live on their own.

Many seniors worry about falling and the consequences of a fall — even if they haven’t fallen yet. It’s likely that they have a friend or neighbor who has fallen or have heard stories of someone who fell, broke their hip, and never recovered. An older adult is treated in an emergency room for a fall every 11 seconds.  

No wonder 30% to 50% of elderly people fear falling more than they fear financial problems, forgetting an appointment, or being scammed or robbed.

When Fear of Falling Leads to Depression

The problem is that when an older adult is anxious and afraid of falling, they stop doing things and withdraw from life. They might refuse to walk outside of the home unassisted or avoid leaving the home altogether.

By limiting their activities and social engagements, they’re actually increasing their risk of falls: When a person is less active, they become weaker, which increases their chances of falling. Plus, the fear of falling and a general loss of confidence can contribute to depression, isolation, and feelings of helplessness. They become even weaker, which increases their chance of falling again. It’s a vicious cycle.

When inactivity leads to depression, a doctor might prescribe medication, but antidepressants have side effects that make someone more liable to fall. Depression can lead to drinking, which also makes someone more likely to fall. And when medication is combined with drinking, things can get really dangerous.

In a study of older adults aged 65 years or older who experienced a fall within the past year, researchers found that the use of antidepressants and depression were found to be significant predictors of repeated falls: Older adults with higher depression scores had a 1.17 times higher risk for repeated falls, and those taking antidepressants were 5.40 times more likely to experience repeated falls.

How to Treat Fear of Falling and Depression

Although it might not be possible to prevent every single fall, there are steps you and your loved one can take to help address these risk factors.

Studies show that exercise — and particularly tai chi — and cognitive-behavioral therapy should be considered for the first-line treatment of mild depression in older fallers. And both are crucial.  

Engaging in even mild exercise on a regular basis is a critical part of fall prevention, so encourage your loved one to stay physically active. Doing strength and balance activities at least three times a week helps make muscles stronger and joints flexible. Exercise also helps treat depression.

When it comes to fear of falling, performing tai chi exercises for at least four weeks has been shown to not only reduce the risk of falls but also reduce the fear of falling in older adults after eight weeks. Tai chi is especially effective because the ancient exercises help elderly people maintain balance and gives them a better body-sense.

Cognitive-behavioral approaches work to reduce the fear of falling by improving self-efficacy and the sense of control over falling. Your loved one doesn’t have to immediately go out and find a therapist, but you can educate your loved one about the risks of falls and what they should do if they fall.

Another way to support your loved one is to actually have them practice getting up off the floor. Being able to get up off the floor provides your loved one a little more independence, which will reduce some of their anxiety and boost their confidence. Bonus: It’s also good exercise for large muscle groups. 

Instead of reinforcing the fear and making things worse in the long run, encourage your loved one to make a fall prevention plan. This Fall Prevention Checklist for Older Adults offers conventional and holistic strategies strengthening the mind, body, and spirit in order to prevent falls. By making some changes, many falls can be prevented, and your loved ones can stay safe, active, and independent longer.