Existing psychological interventions addressing concerns about falling in older adults: a scoping review.

AIMS: Concerns about falling (CaF) are common in older adults. They are associated with increased falls and reduced quality of life. This scoping review aimed to (i) explore the psychological interventions that exist to address CaF in older adults and (ii) determine their feasibility and acceptability. METHODS: The Arksey and O'Malley framework was used to identify all intervention studies that utilised a psychologically informed method to target CaF in older adults. Searches were conducted on five databases (Medline, CINAHL, Embase, Psychinfo and Scopus). RESULTS: This review included 32 interventions (21 randomised controlled trials, five non-controlled trials, two non-randomised controlled trials and four case studies), comprising of 3674 participants. Thirteen different psychologically informed methods were used across interventions. Cognitive behavioural therapy (CBT) was the most common (n = 15), followed by exposure therapy (n = 4) and motivational interviewing (n = 3). Most interventions significantly reduced CaF. The median total dose across all interventions was 5 hours 40 minutes. CBT interventions tended to last the longest (median = 8 × 60-minute sessions). The shortest efficacious intervention involved a single ~20-minute session of motivational interviewing. CONCLUSION: Numerous psychologically informed techniques are currently used to address CaF-with CBT being the most common. However, the time and resource demands of many interventions may challenge their integration into clinical practice. Future work should explore the perspectives of those working in falls prevention services, and older adults themselves, to identify the most feasible and acceptable way to clinically manage CaF.