Purpose: The purpose of this study was to examine the relationship between psychological factors (depression, anxiety, and catastrophizing) and fear of falling avoidance behavior (FFAB) among individuals with Parkinson’s disease (PD). Methods: A secondary analysis of cross-sectional data from 59 individuals with PD using hierarchical multiple regression. Results: Disease severity (Movement Disorder Society - Unified PD Rating Scale) and catastrophizing (Consequences of Falling Questionnaire (CoF)) explained approximately 48.2% of the variance in the FFAB Questionnaire scores ( P < .001). Catastrophizing was the only significant psychological variable ( P < .001). The damage to identity subscale of the CoF was significant in the final model ( P < .001). Conclusions: Catastrophizing about the consequences of falls explained the largest portion of variability in FFAB after controlling for disease severity. Catastrophizing about the immediate consequences of falling may play a prominent role in FFAB and may be a potential treatment target for mitigating FFAB.

Falling and fear of falling (FOF) are significant concerns for people with Parkinson’s disease (PD). FOF can lead to activity avoidance behavior, a risk factor for increased falls and further functional decline. The significant implications of fear of falling avoidance behavior (FFAB) among PD warrant a literature review. The objective of this review was to explore existing literature on FFAB and identify what is known about this phenomenon in people with PD. This scoping review considered studies including adults 18 years and older diagnosed with PD experiencing FFAB. Using Joanna Briggs Institute methodology and the PRISMA extension for scoping reviews, we performed a scoping review searching MEDLINE, Embase, Scopus, APA PsycInfo, CINAHL, Papers First, and ProQuest Dissertations and Theses for studies examining FFAB among people with PD with no limit on publication date. A three-step search strategy was followed and data extraction was performed by two independent reviewers. A total of 9 articles met eligibility criteria. Seven studies were quantitative and two were qualitative. The results identified that FFAB has a significant impact on daily life and is associated with downstream consequences of physical and psychological decline. The symptoms and severity of PD uniquely influence FFAB. Multiple assessments were utilized, but only two measured the impact of FOF and how this fear translates into avoidance behavior. There is a paucity of literature on interventions targeting FFAB among PD. In summary, this review demonstrated that FFAB is complex, multifactorial, and significantly impacts everyday life for people with PD. Evaluation and treatment should begin in the early stages of the disease. PD adds disease-specific symptoms and progression that directly impact FFAB, possibly in a bidirectional or cyclical manner. Further research is required to explore assessment and interventions for FFAB among people with PD.

Introduction: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ) has good psychometric properties. However, a recently modified version (mFFABQ) was theorized to be easier to understand because the updated Likert responses are more consistent with the item stem. This study aimed to examine the reliability and validity of the mFFABQ in older adults and in people with Parkinson’s disease (PD). Methods: A total of 88 participants, 39 with PD (age = 72.2 ± 9.5; 29 males, 10 females) and 49 older adults (age = 72.8 ± 5.0; 13 males, 36 females) answered the mFFABQ twice, separated by one week, for test-retest reliability. Construct validity was evaluated through correlational analyses with fall history, Activities-Specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), Timed Up and Go, 30 Second Sit to Stand, Sensory Organization Test, Zung Anxiety Scale, Beck Depression Inventory; Consequences of Falling Questionnaire (CoFQ), and average daily activity levels using an activity monitor. Results: The mFFABQ had good overall test-retest reliability (ICC = 0.822 (older adult ICC = 0.781, PD ICC = .806). The mFFABQ correlated with fall history (r=-0.430) and exhibited high correlation with the ABC (rho=-.804) and moderate correlations with CoFQ (rho=.582) and BBS (rho=-.595). The mFFABQ also correlated with time stepping (rho=-.298), and number of steps (rho=-.358). Discussion: These results provide supportive evidence for the reliability and validity of the mFFABQ in older adults and people with PD, which supports its suitability as a clinical and research tool for the assessment of fear of falling avoidance behavior.