Psychological and Behavioural Determinants of Fall Prevention in Elderly Individuals Living Independently

Praseart Srenual

Faculty of Public Health Narasuan University

Thanach Kanokthet

Faculty of Public Health Narasuan University

Abstract

Falls constitute a significant public health issue among older adults, frequently resulting in functional deterioration, diminished autonomy, and greater healthcare demands. In addition to physical frailty, behavioural factors play a crucial role in determining fall risk and adherence to preventive measures among elderly individuals living independently. Psychological elements, including fear of falling and risk perception, interact with everyday behaviours such as engagement in physical activity, implementation of home safety practices, and participation in social activities. This study aims to identify key psychological and behavioural factors influencing fall prevention in community-dwelling older adults who maintain independent living. Data were collected from 3,850 adults aged 65 years and older residing independently, utilising structured questionnaires. Psychological variables were assessed using validated instruments measuring fall-related self-efficacy, emotional distress, and cognitive function, whereas behavioural factors encompassed exercise frequency, use of assistive devices, and patterns of medication management. Multivariate logistic regression, structural equation modelling, and reliability analyses were conducted using Statistical Package for the Social Sciences (SPSS) and Analysis of Moment Structures (AMOS) to determine both direct and indirect relationships between the identified determinants and fall prevention outcomes. Findings revealed that greater self-efficacy in fall prevention, regular participation in balance-focused exercise, proactive modification of home hazards, and robust social engagement were associated with a significant reduction in fall incidence (p < 0.05). In contrast, higher levels of fear of falling and depressive symptoms were correlated with lower engagement in preventive behaviours and a heightened likelihood of falls. These results underscore the importance of enhancing psychological resilience and encouraging adaptive safety behaviours as integral elements of comprehensive fall prevention interventions for independently living older adults.

Fall Prevention, Psychological Determinants, Behavioural Risk Factors, Independent Older Adults, Fear of Falling, Community-Based Aging behavior.