Emotional stress may raise older adults' fall risk

By Amy Norton

NEW YORK, 28 feb 2009– While physical frailty puts elderly adults at risk of falls and bone fractures, emotional distress can be the immediate trigger of some of those accidents, new research suggests.

In a study of older adults hospitalized for fall-related hip fractures, Swedish researchers found that the patients' odds of suffering a fall were elevated for up to one hour after an emotionally upsetting event.

The risk rose by 12-fold following a bout of anger, and by 20 times after a generally stressful incident. Meanwhile, sadness was linked to a nearly 6-fold increase in the risk of a fall-related fracture, the researchers report in the online journal BMC Geriatrics.

The study cannot reveal why emotional distress might contribute to falls. But one possibility is that it distracts elderly adults' attention away from maintaining their posture and balance, according to Dr. Jette Moller and colleagues at the Karolinska Institute in Stockholm.

Stress might also interfere with older adults' visual focus, another key to maintaining balance and preventing falls.

"We think it is good if elderly adults are aware that emotional stress might interfere with (their) attention while walking, standing or while changing posture," Moller told Reuters Health.

Emotional stress may not be avoidable, she noted, but people can alter their reactions to it. When emotions are running high, older adults might be better off sitting down until the stress has passed, Moller suggested.

That could be especially important for people at high risk of falling due to physical impairments or poor vision, the researcher added.

The study involved 137 patients age 65 and older who were treated for a fall-related hip fracture at one of two hospitals. Nurses interviewed each patient about the injury and the activities they'd been involved in over the two days prior to the accident.

They also asked the patients whether and when they'd had any feelings of anger, sadness, worry, anxiety or stress during that time.

While most patients did not report any emotional stress shortly before their fall, episodes of anger, stress or sadness did appear to precipitate falls in a small number of patients.

This appears to be the first study to find a link between emotional distress and falls, according to Moller's team. More studies, the researchers say, are needed to confirm the findings, and to uncover the reasons for the connection.

SOURCE: BMC Geriatrics, online February 9, 2009.