Fear of Falling and Fall Risk in Older Adults: An Integrated Analysis Based on the Polyvagal Theory

This study aimed to investigate the relationship between fear of falling and actual fall experience among community-dwelling older adults and to identify the factors influencing fall risk comprehensively.A secondary data analysis was conducted using the 2019 Elderly Safety Awareness Survey from County Y in Chungnam Province, which included 3,534 older adults.The study employed a descriptive cross-sectional design.The independent variables included general characteristics, physical factors (ADL, subjective health), psychological factors (fear of falling), and behavioral/environmental factors (fall prevention education, use of assistive devices, lighting, handrail installation).A logistic regression analysis was performed with fall experience (yes/no) as the dependent variable.The results showed that women had a lower risk of falling (OR = 1.441, p = .010).Higher ADL scores were associated with reduced fall risk (OR=0.982,p=.000).Fear of falling, as a psychological factor, was significantly associated with fall experience (OR=4.568,p<.000).The use of assistive devices was also identified as a factor increasing fall risk (OR=1.310,p=.038).These findings suggest that fear of falling may be linked to actual fall risk, not merely as an emotional response but as part of an integrated mechanism involving physiological reactions of the autonomic nervous system.Therefore, a multidimensional intervention that considers psychological, physical, and environmental factors is required for effective fall prevention.