Selective Attentional Processing to Fall-Relevant Stimuli Among Older Adults Who Fear Falling

Abstract

Fear of falling is known to affect more than half of community-dwelling older adults over 60 years of age. This fear is associated with physical and psychological effects that increase the risk of falling. The authors' theory is that attentional processing biases may exist in this population that serve to perpetuate fear of falling and subsequently increase fall risk. As a starting point in testing this proposition, the authors examined selective attentional processing bias to fall-relevant stimuli among older adults. Thirty older adult participants (M _age = 70.8 ± 5.8), self-categorized to be Fearful of Falling (FF, n = 15) or Non-Fearful of Falling (NF, n = 15) completed a visual dot-probe paradigm to determine detection latencies to fall-threatening and general-threat stimuli. Attentional processing was defined using three index scores: attentional bias, congruency index, and incongruency index. Bias indicates capture of attention, whereas congruency and incongruency imply vigilance and disengagement difficulty, respectively. Both groups showed an attentional bias to fall-threat words but those who were fearful of falling also showed an incongruency effect for fall-threat words. These findings confirm that selective attentional processing profiles for fall-relevant stimuli differ between older adults who exhibit fear of falling and those who do not have this fear. Moreover, in accordance with current interpretations of selective attentional processing, the incongruency effect noted among fall-fearful older adults presents a possibility for a difficulty disengaging from fall-threatening stimuli.

Acknowledgments

The authors thankfully acknowledge the time contributions of the raters (anonymity requested). This project was funded by the Natural Sciences and Engineering Research Council of Canada.

Notes

Note. Data are mean (SD). **p < .0001.

ABC = Activities-specific Balance Confidence scale (Powell & Myers, 1995); STAI-S = State-Trait Anxiety Inventory—State (Spielberger et al., 1983); STAI-T = State-Trait Anxiety Inventory—Trait (Spielberger et al., 1983); GDS = Geriatric Depression Scale (Yesavage & Brink, 1983); MMSE = Mini-Mental Status Examination (Folstein et al., 1975).

Note. Data are mean (SD). U = upper; L = lower.

U = upper; L = lower.