Correlation between Activity Restriction and Fear of Falling in Community Dwelling Indian Older Adults: A Cross-sectional Study

Introduction: Fear of Falling (FoF) is a prevalent and debilitating concern among older adults, often leading to self-imposed activity restriction, reduced mobility and diminished quality of life. In the Indian context, these challenges are compounded by underreporting, limited awareness and insufficient geriatric support systems related to falls. Aim: To examine the relationship between FoF and activity restriction among community-dwelling Indian older adults using the Falls Efficacy Scale-International (FES-I) and the Balance Confidence Scale (BCS). Materials and Methods: A cross-sectional study was conducted on 220 community-dwelling Indian older adults. The approval from the Institutional Ethics Committee (IEC) was obtained and data collected. The collected data included demographic information, fall history, fall frequency, number of medical conditions, FES-I and BCS scores. Activity restriction was evaluated with a set of questions regarding safe engagement in mobility and community activities. Statistical analyses were performed using IBM Statistical Package for the Social Sciences (SPSS) Statistics version 27.0. Pearson correlations were computed and multiple linear regression was conducted to predict the number of activities restricted based on age, total FES-I score, number of falls in the last year, number of medical conditions and total BCS score. Significance was set at p-value <0.05. Results: Of the 220 participants (mean age=68.51±6.50 years), 65 (29.6%) reported at least one fall in the past year, with varying activity restriction. Significant correlations were found between the number of restricted activities, FES-I score, falls and medical conditions. The regression was significant, F(5, 214)=34.79, p-value <0.001, explaining 44.8% of the variance in activity restriction (R2 =0.45, Adjusted R2 =0.44). Significant predictors of activity restriction were the number of falls (B=0.75, p-value=0.01), medical conditions (B=0.86, p-value <0.001), and FES-I score (B=0.19, p-value <0.001), while age (p-value=0.39) and BCS score (p-value=0.18) were non significant. Conclusion: FoF is closely linked with activity restriction among community-dwelling Indian older adults, posing a serious risk to independence and quality of life. Early screening and addressing FoF and balance confidence can support safe ageing and functional independence, as these reflect possible limitations even before actual limitations manifest.