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

This study determined the extent to which pain and depression influenced changes in fear of falling, mobility, and balance in older veterans with mobility disorders. Data were reviewed from 95 consecutive patients (aged 60 to 95 yr) who attended the Geriatric Gait and Balance Disorders Clinic at the Malcom Randall Department of Veterans Affairs Medical Center between 1998 and 2000. All subjects performed an individualized exercise program and were assessed four times over 12 weeks with a standardized evaluation battery. We used separate hierarchical regression models to examine the influence of measures of bodily pain and depression on outcomes (Berg Balance Test, Dynamic Gait Index, and Falls Efficacy Scale). Approximately half of the patients attended all evaluation sessions. Attendance at follow-up visits was a significant predictor of improvement in all outcome measures. Pain was a significant predictor of a decrease in balance and mobility outcome scores but not fear of falling. Thus, completing the program increased the amount of improvement, while having pain decreased the amount of improvement. These data suggest that targeted interventions for pain and improving adherence to rehabilitation recommendations should be included in the rehabilitation of older veterans with balance or mobility disorders to maximize potential improvements in balance and mobility.