Loose throw rugs, cracked sidewalks, toys and pets underfoot — coupled with stiff joints and visual decline — can make the daily movements most take for granted a hazard for older adults. But a new study, reported in the April 2008 Journal of the American Geriatrics Society, suggests that those who restrict their activities because of fear of falling face the risk of rapid physical decline.

Researchers from the University of Kansas Medical Center in Kansas City studied a group of 673 Italian adults aged 65 or older and found that the more a person limited his or her activities due to a fear of falling, the more likely they were to experience a deterioration of physical functioning over the next three years.

The study found that 15 percent of participants admitted to avoiding three or more activities such as outdoor walking, shopping, and visiting friends and relatives due to fear of falling. When followed over the next three years, these persons suffered increasing physical limitations, such as difficulties with dressing, bathing or getting in and out of bed. And when mobility testing performed at the beginning of the study was repeated three years later, results showed a more rapid decline for those with "fear-induced activity restriction."

Even those 60 percent who put fewer restrictions on themselves had increased difficulty with complex physical tasks like cooking, shopping for groceries, and cleaning the house compared with those who didn't restrict their activities at all.

Why is fear of falling linked with physical decline? Restricting physical activity affects cardiovascular fitness and muscle strength as well as the functioning of nerves and muscles that rely on the feedback from moving to stay sharp, explains lead researcher Dr. Nandini Deshpande.

Deshpande recommends that older adults who self restrict activities due to fear of falling consult their physicians. An exercise program to improve balance, such as Tai chi, she says, along with cognitive therapy programs designed to help seniors confront and change the often unconscious thoughts and fears that contribute to their inactivity may help to boost older adult's confidence and help to keep them active.