Reconceptualizing the role of fear of falling and balance confidence in fall risk.

OBJECTIVE This article aimed to critically examine preexisting conceptualizations of the relationship among fear of falling, falls efficacy, and falls and to offer a new theoretical model incorporating findings from the recent literature. METHOD This is a theoretical article based on a review of preexisting findings pertaining to fear of falling and falls efficacy. RESULTS Traditional conceptualizations consider avoidance of activity and deconditioning to be mediators in the relationship between fear of falling and falls, but recent findings suggest that this mediational conceptualization may not be accurate. Moreover, the terms falls efficacy and fear of falling are often used interchangeably in the literature, which is conceptually problematic. DISCUSSION We conclude with the presentation and discussion of an alternative predictive model of fear of falling that incorporates important findings from the recent literature.