Predictors of low/moderate vs high concerns about falling among older adults with poor mobility

Older adults with poor mobility often experience concerns about falling (CAF), which may increase their risk for mental and physical health declines. While prior research links CAF to poorer cognition, gait, and psychological factors in healthy older adults, it is unclear whether these associations hold in those with mobility limitations. This study aimed to identify predictors of high CAF in older adults with poor mobility.

Eighty-five adults aged ≥65 years (low/moderate CAF: n = 40, 77.6 ± 7.3 years, 65.0% female; high CAF: n = 45, 81.8 ± 8.6 years, 53.3% female) with self-reported poor mobility and no neurological conditions from the community and residential care settings completed assessments of cognition, depression, perceived health status, gait speed, and functional strength. Participants reported their CAF using the 16-item Falls-Efficacy Scale-International (FES-I); previously defined cut-points were used to differentiate between participants with low/moderate concerns (FESI: 16-27 points) and high concerns (FESI: 28-64 points).

Binary logistic regression (adjusting for age, sex, and education) showed that higher MoCA scores [OR = 1.51, CI = 1.11,2.06], greater depression [OR = 3.18, CI = 1.67,6.04], slower gait speed [OR = 0.005, CI ≤0.00,0.18], and slower Sit to stand score [OR = 0.57; CI = 0.33,0.98] predicted high CAF. The model's classification accuracy was 80.7% (χ²₍₈₎ = 52.01; R² = 0.62, p < 0.001).

While greater depression, slower gait, and reduced strength predicted high CAF - as in prior research - better cognition also did, possibly reflecting greater fall risk awareness without the physical capacity to respond. These findings may inform screening in this high-risk group.