Fear of falling (FoF) is widespread among older adults, with an estimated global prevalence of 49.60%, ranging from 6.96% to 90.34%. FoF is often considered a result of psychological stress following a fall but can also occur in older individuals without any previous falls. Previous studies have suggested the involvement of various brain regions and fear-related brain circuits in FoF. However, evidence linking brain hemodynamic responses to FoF remains limited. In this study, we examined the association between FoF and hemodynamic changes induced by brain activation, as measured by functional near-infrared spectroscopy (fNIRS). The study population was 308 older adults recruited from Korea's Seoul Veterans Health Service Medical Center. fNIRS data were collected using NIRSIT Lite (OBELAB Inc., Seoul, Republic of Korea), and hemodynamic changes in the prefrontal cortex were measured through fluctuations in oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin concentrations. FoF was assessed using the Activities-Specific Balance Confidence (ABC) scale. In linear regression analysis, an increase in HbO2 levels was significantly associated with lower ABC scores (indicating higher FoF), with consistent results across brain regions. The association remained significantly robust after adjusting for sociodemographic factors, health behaviors, and medical conditions. When stratified by fall experience and major demographic characteristics, the association was more significant in individuals who had experienced falls, were over 75 years old, were female, and had a high school education or less, compared to their counterparts. This study provides novel evidence that FoF is significantly associated with reduced brain hemodynamic responses.

Authors:
Jin-Young Min, Veterans Health Service Medical Center, South Korea
Kyoung-Bok Min, Seoul National University, South Korea
Seok-Yoon Son, Seoul National University, South Korea
Baek-Yong Choi, Seoul National University, South Korea
Seung-Woo Ryoo, Seoul National University, South Korea

About the Presenter(s)
Dr. Min is currently the Director of the Research Division at the Veterans Medical Research Institute, Veterans Health Service Medical Center in Seoul in the Republic of Korea.

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