Discrepancies between fall risk and fall awareness in hospitalized elderly patients with cataracts: a cross-sectional study

Objective To investigate the discrepancies between fall risk and fall awareness among hospitalized elderly cataract patients, providing a basis for implementing precise fall prevention assessments and interventions in clinical practice. Methods Using convenience sampling, 526 elderly cataract patients hospitalized in a tertiary hospital in Shanghai from March 2025 to September 2025 were selected as study subjects. A cross-sectional survey was conducted using a general information questionnaire, the Johns Hopkins Fall Risk Assessment Scale, and the Fall Awareness Scale to analyze the distribution characteristics and differences between fall risk and fall awareness, and to compare the differences in their influencing factors. Results The fall risk score of hospitalized elderly cataract patients was (6.56 ± 3.44), indicating a moderate level, while the fall awareness score was (54.45 ± 11.27), also indicating a moderate level. There was no significant difference ( χ 2 = 3.074, p > 0.05) in fall awareness scores among hospitalized elderly cataract patients with different fall risk levels. In the high-risk group, 62.50% (25/40) of patients exhibited insufficient awareness; in the medium-risk group, 35.20% (107/304) showed insufficient awareness, while 27.96% (85/304) exhibited excessive awareness; in the low-risk group, 67.58% (123/182) displayed excessive awareness. Factors associated with fall risk included age, marital status, education level, sleep quality, residence, medication history, underlying diseases, etc. Conclusion This study clearly demonstrates the widespread risk-awareness mismatch among hospitalized elderly cataract patients. Hospitalized elderly cataract patients exhibit a moderate level of fall risk but widespread fall awareness deviations, characterized by insufficient awareness among high-risk patients coexisting with excessive awareness among low-risk patients. Simple assessment of objective fall risk fails to identify patients’ subjective cognitive biases. It is recommended to incorporate fall awareness assessment into routine nursing screenings to implement individualized and precise fall prevention interventions.