Self-rated fall risk and its associated factors among older adults: a community-based cross-sectional study in rural...

Falls are a major cause of morbidity and mortality among older adults worldwide, particularly in low- and middle-income countries (LMICs). Rural older populations may be at increased risk due to environmental hazards, multimorbidity and limited access to preventive services. This study aimed to assess the prevalence of high fall risk and identify its associated factors among older adults living in rural Minia Governorate, Egypt.

A community-based cross-sectional study was conducted among 325 adults aged ≥60 years residing in two rural villages in Minia Governorate between September and December 2024. Data were collected through face-to-face interviews using a structured questionnaire covering sociodemographic characteristics, health conditions, nutritional status, physical activity and environmental risk factors. Fall risk was assessed using the validated Arabic version of the Fall Risk Questionnaire (FRQ).

More than half of the participants (57.8%) were classified as having a high risk of fall. In univariate analysis, variant socioeconomic, health-related and environmental factors were associated with high fall risk. In multivariate analysis, age ≥75 years (OR=4.26), having three or more comorbidities (OR=21.69), poor self-rated health status (OR=7.36), physical inactivity (OR=2.79), and exposure to multiple environmental hazards (OR=2.79) emerged as independent predictors of high fall risk.

There is a high burden of fall risk among rural older adults in Minia Governorate and it is driven by a combination of health-related vulnerabilities and environmental hazards. Integrating fall risk screening, home safety assessment, management of chronic conditions and promotion of physical activity into rural primary healthcare services is essential to support healthy ageing and reduce fall-related burden.