FRIDAY, Aug. 20 (HealthDay News) -- Older people who have a fear of falling are at increased risk for future falls, regardless of their actual risk of tumbling, a new study finds.

The report, published online Aug. 20 in the BMJ, suggests that fall risk assessments should include measures of both actual and perceived fall risk for prevention purposes, according to the Australian and Belgian researchers.

The study included 500 people in Sydney, aged 70 to 90, who underwent extensive medical and neuropsychological assessments. The researchers estimated the participants' actual and perceived fall risks and followed-up on them monthly for one year.

Both actual and perceived fall risk contribute independently to a person's future risk of falling, the study authors concluded. People with a high level of anxiety about falling are most likely to suffer a fall.

Although most people had an accurate perception of their fall risk, about one-third of the elders either underestimated or overestimated their risk of falling, according to senior principal research fellow Stephen Lord, of the Falls and Balance Research Group, Prince of Wales Medical Research Institute at the University of New South Wales, and colleagues.

The "anxious" group, for example, had a low actual fall risk but viewed it as high -- something the researchers attributed to neurotic personality traits, symptoms of depression and poor physical functioning. The "stoic" group, on the other hand, had a high actual fall risk but viewed it as low, an attitude that the researchers associated with physical activity, a positive outlook on life and community participation. The perception of a low fall risk actually helped protect the stoic group against falls, the investigators found.

Working with elderly people to reduce their fear of falling isn't likely to increase the risk of falls by making seniors overly confident, Lord and colleagues noted.

More information

The U.S. National Institute on Aging has more about seniors and falls.