Prevalence of falls and fear of falling in older adults: a multidimensional analysis based on comprehensive geriatric assessment

Objectives To assess the prevalence of falls and fear of falling in community-dwelling older adults and identify associated factors. Methods A cross-sectional study was conducted of 400 older adult users of a primary healthcare unit in São Paulo, Brazil. Sociodemographic, clinical, cognitive, and function data were collected. Falls were evaluated through self-report, and fear of falling was measured using the Falls Efficacy Scale-International (FES-I). Hierarchical regression was used to analyze associations. Results The sample had a mean age of 75.23 (SD: 8.53) years, and a predominance of females (63.2%). The prevalence of falls was 62.7%, with 20.3% reporting falls in the past 12 months. Fear of falling was reported by 90.5%. Younger age was associated with a lower risk of falls (OR=0.93; p=0.003). Female sex (OR=3.78; p<0.001), poor self-rated health (OR=9.62; p=0.001), previous hospitalizations (OR=3.13; p<0.001), and worse cognitive function (OR=1.14; p=0.012) were associated with an increased risk of falls. Factors associated with fear of falling included older age (β=0.288; p<0.001), female sex (β=-12.265; p<0.001), history of falls (β=7.448; p=0.001), and dependence for instrumental activities (β=2.532; p=0.027). Conclusion Multidimensional interventions in primary care are essential to prevent falls and mitigate fear of falling, promoting quality of life in the Brazilian older population.