Fear and Anxiety in Older Adults and Its Impact on Postural Control

Recent evidence confirms that fear of falling is highly prevalent in older adults and represents an important contributing factor to future fall risk. The primary focus of this chapter is to examine current evidence derived from group comparisons and within-subject experimental designs to demonstrate how emotions such as fear and anxiety influence balance across different types of postural tasks in young and older adults. The results provide compelling evidence for an indirect and direct effect of fear and anxiety on all aspects of postural control, including changes in performance on clinical balance assessments and posturographic measures of static and dynamic balance control. Both young and older adults respond to threat and anxiety conditions in static and dynamic balance tasks with a combination of context-dependent protective strategies, and potentially maladaptive or inefficient neuro-muscular changes that are tightly coupled to anxiety and fear responses. The evidence of emotion-balance interactions in young and older adults provides important insight on the physiological, psychological, and social-cognitive interactions that contribute to human postural control and highlights the need to account for the potential confounding influence of anxiety and fear when performing balance assessments, and designing treatment and intervention solutions for age-related balance deficits.