ABS 020: The Impact of Fear of Falling on Brain Activity and Cognitive Performance in Older Adults

Rachel Smith, Brad Manor, Melike Kahya

Van Wickle (2025) Volume 1, ABS 020

Introduction: Elevated fear of falling (FoF) among older adults is associated with an increased risk of cognitive decline. Previous research has indicated that reduced electroencephalogram (EEG) alpha activity in frontal regions is correlated with diminished cognitive performance, particularly in areas of attention and executive function. Nevertheless, the interplay between FoF and brain activity related to attention and executive function remains insufficiently explored. This cross- sectional research aimed to understand the effect of FoF on resting-state EEG alpha power and cognitive performance in older adults. We hypothesized that older adults with high FoF would demonstrate reduced alpha power and decreased cognitive performance compared to older adults with low FoF. Twenty-two participants (age: 75±7 years; 16 females) completed the Falls Efficacy Scale and were divided into low FoF (<18; n= 14) and high FoF (>18; n= 8) groups. They also completed a cognitive test battery (Montreal Cognitive Assessment, Hopkins Verbal Learning Test, Digit Span, Digit Symbol Substitution Test, Trail Making Tests, and Verbal Fluency) and a resting-state EEG. Independent Sample t-test results indicated that older adults with high FoF had lower alpha power in the anterior left region compared to those with low FoF (p = 0.007). While cognitive test scores did not significantly differ between groups, a trend towards lower Digit Symbol Substitution Test performance was observed in the high FoF group (p = 0.05). These results suggest that high FoF is associated with reduced alpha power and potentially impaired executive function and attention. Further research is needed to investigate the neurophysiological mechanisms underlying these observed relationships, as well as to determine the timing of changes in FoF, alpha brain power, and cognitive decline which can provide deeper insights into their interconnections.