Fear itself may be the simplest diagnostic tool Australia is not yet using.
A global review led by Neuroscience Research Australia (NeuRA) has found that asking older adults a single question “Are you worried about falling?” reveals an independent risk factor for real-world falls, injuries and costly hospital stays.
Professor Kim Delbaere, senior research scientist at NeuRA and lead author of the 53-study meta-analysis said, “Many older Australians develop concerns about falling, and this concern itself increases their risk of future falls.”
The review pooled data from more than 75,000 people in 15 countries. Even after researchers adjusted for age, previous falls and balance problems, high “concern about falling” still predicted who would fall next. That pattern makes worry about falls “not just a reflection of physical frailty but an independent factor influencing future falls,” Delbaere added.
In Australia, falls already send about 400 people a day to hospital and often trigger a downward spiral of disability, social isolation and early entry into aged care facilities. The new findings suggest fear is both a cause and a consequence of that spiral: prior falls breed anxiety and anxiety breeds future falls.
Nearly half of Australians reach age 85 with measurable concern about falling, the study shows. Left unaddressed, that apprehension limits activity, erodes confidence and chips away at strength, further magnifying risk.
Researchers say it should become routine in GP surgeries, physiotherapy sessions and residential care assessments.
“The first step in prevention is starting the conversation. Many older adults don’t talk about their concerns unless asked,” Delbaere said. “By routinely discussing concerns about falling, healthcare professionals, families and caregivers can help older adults take early action to stay active and independent.”
Related: Study ties aged care falls to ‘inappropriate’ antidepressant use
Once fear is flagged, effective interventions already exist: strength and balance classes, tailored exercise, cognitive-behavioural therapy and home-safety modifications. Evidence suggests such measures can prevent up to one-third of falls.
“Falls are not an inevitable part of ageing — they are preventable,” Delbaere said. “It’s time for Australia to invest in a coordinated national strategy and make falls prevention a public health priority, not an afterthought.”
The 2022 World Falls Guidelines already recommend asking about fear of falling; the NeuRA-led review supplies the hard data to back that advice. Advocates hope it will push health systems to treat “concern about falling” as a new vital sign, one that can be measured in seconds and, if acted on, save thousands of hospital beds each year.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
