Broken spirits, not bones, may be the worst result of falling down. Many older people fall, but for some, the experience makes them so afraid of toppling again that their mind impairs their ability to walk without trembling or losing balance. They quickly make themselves dependent on canes or wheelchairs. Roger Kurlan, a neurologist at the University of Rochester, has seen about 30 cases of what he calls “fear of falling” gait.

The condition may also make individuals vulnerable to dangerous misdiagnoses. One 76-year-old woman was seen by a doctor who noticed her tremor and inability to walk unaided and prescribed medication for Parkinson's disease. After subsequently talking with her, Kurlan managed to get her out of her wheelchair, and she was soon walking securely around his office. He is now encouraging physicians who spot such symptoms to ask patients about recent falls, instead of assuming a neurological problem and prescribing unnecessary medication, physical therapy or even institutionalization.