- Design
- Randomised, sham-controlled trial
- Population
- 160 community-dwelling adults aged ≥70 with concerns about falling
- Primary outcome
- Concerns about falling at 8-month follow-up
- Effect
- No between-group difference; both groups improved
The FEARFALL trial randomised 160 community-dwelling adults aged 70 or over with concerns about falling to a four-month programme of exercise and cognitive-behavioural training or to a sham control, and followed them to eight months.
Concern about falling improved over time in both groups, with no difference between them. Salivary cortisol, alpha-amylase and inflammatory markers changed similarly in both arms, and physical function changed only marginally.
Multicomponent programmes for fear of falling are widely recommended. This trial suggests that part of the improvement seen in uncontrolled studies may come from attention, contact and time rather than the specific content. That does not make the programmes worthless, but it tempers expectations.
- Ask about concern about falling at every falls assessment — it limits activity.
- Do not expect a specific programme to outperform supportive contact on fear alone.
- Keep strength and balance training for its effect on falls, which is established.
- Reassess concern about falling over time; it often improves.
Why it matters
It challenges the assumption that the specific content of fear-of-falling programmes is what helps.
Don't overread it
160 participants and a sham that itself involved contact; a smaller specific benefit is not excluded.
The statistics, in plain English
When both groups improve equally, the improvement comes from something they share — time, attention or regression to the mean — rather than the intervention itself. The abstract does not give effect sizes, so the precision of the null result is unknown.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for geriatrics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free