"Among middle-aged African-Americans, there's this huge fear of falling"

Fear of falling, once believed to be mostly a senior citizen problem, is striking African-American middle-aged adults with negative consequences to their health, new Saint Louis University research finds.

African-American middle-aged adults – some as young as 50 – say they are so afraid of falling that they become less active, which creates a cycle that causes frailty and illness, according to findings in the May issue of the Journal of Gerontology: Medical Sciences.

"Among middle-aged African-Americans, there's this huge fear of falling – which many of us thought existed only in older adults," says Margaret Mary Wilson, M.D., assistant professor of geriatrics at Saint Louis University School of Medicine and the principal investigator who conducted the research.

"This is strange because this fear of falling exists in people who have never fallen before. It's an illogical fear. Yet they're so afraid of falling that they avoid activities. It becomes a self-fulfilling prophecy. They become weak and they fall."

Fear of falling was "surprisingly high" among middle-aged African-Americans who live in the inner city. About one in three people feared falling, making the fear as common among these middle-aged adults as it is among the elderly.

The study examined 998 African-American participants, some from a poor inner city St. Louis neighborhood and some from a more affluent suburban community.

Interviewers paid home visits to study participants, and asked them questions as well as performed simple health and activity screenings. More study participants from the poorer neighborhood said they were afraid of falling than those from the suburbs.

"In this population-based sample of 49- to 65-year-old African-Americans, fear of falling and fear-related activity restriction were surprisingly common and not well explained by prior falls," she says. "These phenomena were already evident by age 49 to 55."

Wilson says she doesn't know the precise reason for the disparity, but has some ideas.

"It is possible that the increased risk of environmental hazards, inadequate resources and socioeconomic disadvantage in inner-city neighborhoods increase the perception of fall risk among resident elders," she says.

Dr. Wilson called for more research to see at what age the fear of falling first develops and to learn why the phobia appears to strike minorities harder than majority populations.

"In the meantime, clinicians should be aware that fear of falling is common even in middle-aged patients and that the associated activity restrictions can have numerous adverse consequences, including premature death," she says.