Multidomain Vulnerability and Fear of Falling in Mexican American Older Adults: A Repeated Measures Analysis

To examine how multidomain vulnerability relates to fear of falling among Mexican American older adults across repeated survey waves.

This was a secondary analysis of three waves (2012-2021) of the H-EPESE study with 893 person-wave observations. Fear of falling was the ordinal outcome. A vulnerability index combined four indicators: mobility impairment, depressive symptoms, loneliness, and urinary incontinence. Ordinal GEE models adjusted for age, sex, cognitive status, and survey wave.

Multidomain vulnerability was strongly associated with fear of falling. Compared to low vulnerability, moderate vulnerability nearly tripled the odds (OR = 2.45) and high vulnerability increased them nearly fivefold (OR = 4.81; both p < .001). Age and survey wave were not significant after adjustment. Women had greater odds than men (OR = 1.52, p = .004).

Fear of falling was more strongly tied to accumulated vulnerabilities than to age or time alone. Multidomain screening can improve risk identification and guide person-centered care.

Fear of falling assessments should address mobility, mood, social connectedness, and continence together. Older adults carrying multiple vulnerabilities benefit most from integrated care across physical, psychological, and social domains to reduce fear and prevent functional decline.