Influence of pain and depression on fear of falling, mobility, and balance in older male veterans.

Abstract— This study determined the extent to which pain anddepression influenced changes in fear of falling, mobility, andbalance in older veterans with mobility disorders. Data werereviewed from 95 consecutive patients (aged 60 to 95 yr) whoattended the Geriatric Gait and Balance Disorders Clinic at theMalcom Randall Department of Veterans Affairs Medical Cen-ter between 1998 and 2000. All subjects performed an individu-alized exercise program and were assessed four times over12 weeks with a standardized evaluation battery. We used sep-arate hierarchical regression models to examine the influenceof measures of bodily pain and depression on outcomes (BergBalance Test, Dynamic Gait Index, and Falls Efficacy Scale).Approximately half of the patients attended all evaluation ses-sions. Attendance at follow-up visits was a significant predic-tor of improvement in all outcome measures. Pain was asignificant predictor of a decrease in balance and mobility out-come scores but not fear of falling. Thus, completing the pro-gram increased the amount of improvement, while having paindecreased the amount of improvement. These data suggest thattargeted interventions for pain and improving adherence torehabilitation recommendations should be included in the reha-bilitation of older veterans with balance or mobility disordersto maximize potential improvements in balance and mobility.