Association Between Anxiety, Education Level, and Fall Risk Among Community-Dwelling Older Adults

Background:Falls are a major public health concern among older adults.This cross-sectional study investigated fall incidence among community-dwelling older adults and examined the independent and interactive effects of education level and anxiety. Material/Methods:A questionnaire survey of 211 community-dwelling older adults collected demographic and fall data.The Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Mini-Mental State Examination (MMSE) assessed mental and cognitive function.A wearable smart belt measured gait speed and Five Times Sit-to-Stand performance.Univariable and multivariable logistic regression identified fall-related factors, with sensitivity analyses assessing robustness. Results:Of 243 eligible individuals, 211 participated (86.8%) and completed all assessments.Mean age was 72.51 ± 5.29 years.Six-month fall incidence was 32.2% (68/211).After full adjustment, higher education (junior college and above: adjusted OR = 15.924,95% CI: 4.012-63.185,P < 0.001) and GAD-7 score (adjusted OR = 1.211, 95% CI: 1.018-1.441,P = 0.031) were independently associated with increased fall risk, with no significant interaction (P = 0.252).Fall incidence was lower among participants with primary school or below (adjusted P < 0.001), junior high school (adjusted P < 0.001), and vocational/high school education (adjusted P = 0.001) than among those with junior college or above.Mild anxiety (50.0%, 10/20) and moderate-severe anxiety (50.0%, 2/4) were associated with higher fall incidence than no anxiety (29.9%, 56/187); differences were not significant after Bonferroni correction (adjusted P > 0.05). Conclusions:Self-reported fall incidence remains high among community-dwelling older adults.Higher education is independently associated with increased risk.Older adults with higher education should be prioritized for fall risk monitoring and targeted screening.