The effect of osteoporosis on fall risk, balance, and fear of falling in postmenopausal women: a controlled cross-sectional study.

BACKGROUND

Osteoporosis in postmenopausal women increases fracture risk, with falls being a primary contributor. Fear of falling is a factor that can lead to activity avoidance, paradoxically increasing deconditioning and fall risk.

AIMS: This study aimed to investigate the effects of osteoporosis on fall risk, balance and fear of falling in postmenopausal women compared to a healthy Control Group.

METHODS

This cross-sectional study included 102 postmenopausal women (51 in the Osteoporosis Group, 51 in the Control Group). Participants were grouped based on Dual Energy X-ray Absorptiometry (DEXA) T-scores (Osteoporosis ≤ -2.5). Fear of falling was assessed using the Falls Efficacy Scale International (FES-I). Pain intensity was measured with Visual Analogue Scale (VAS), while functional mobility and balance were assessed using the Timed Up and Go Test (TUGT).

RESULTS

The Osteoporosis Group had significantly higher rates of fracture history (p=0.013) and falls in the last year (p<0.001). This group also demonstrated significantly higher VAS, TUGT, and FES-I scores (all p<0.001). FES-I scores correlated positively with VAS (r=0.522) and TUGT (r=0.509), and negatively with femoral neck/lumbar T-scores and bone mineral density (BMD) values (p<0.001 for all).

CONCLUSION

Postmenopausal women with osteoporosis experience a higher fall frequency, greater fear of falling, increased pain, and poorer functional mobility compared to controls. Fear of falling was strongly correlated with lower BMD, higher pain, and poorer TUGT performance. Osteoporosis management should not solely focus on BMD, but must also incorporate strategies to address pain, functional mobility, and the psychological burden of fear of falling.