The relationship between psychological resilience and fear of falling in older adults with fractures: a cross-sectional potential profile analysis

This is a cross-sectional study designed to identify the latent profiles of psychological resilience in elderly patients with fracture and examine the relationship between resilience categories and fear of falling (FOF), thereby informing individualized rehabilitation strategies. A convenience sample was drawn from elderly patients admitted to the Department of Traumatology and Orthopedics at a tertiary general hospital in Beijing between September 2024 and July 2025 due to fall-related fractures. A total of 213 older adults aged 60 and above with fall-related fractures were included. Psychological resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC), and FOF was measured with the Falls Efficacy Scale-International (FES-I). Latent Profile Analysis (LPA) was used to identify resilience profiles. Logistic and linear regression analyses, adjusting for age, sex, comorbidities, pain level, functional status, and time since fracture/surgery, were performed to explore the relationship between resilience subtypes (entered as a continuous CD-RISC score), demographic and clinical factors, and FOF levels. The age of elderly patients with fall-related fractures was 60–98 (75.28 ± 8.73) years old, and the median age was 74 years old. Three latent resilience profiles were identified: low (33.5%), moderate (22.7%), and high (43.8%) resilience groups. Patients in the high-resilience group exhibited significantly lower FOF scores than those in the other two groups (P < 0.001). Multivariate regression revealed that social support, fracture site, use of walking aid, fall history and lower psychological resilience were significant predictors of FOF (P < 0.05). Notably, vertebral fractures were associated with the highest FOF levels (β = 9.16, P < 0.001). Psychological resilience is independently associated with fear of falling among elderly fracture patients, with a clear gradient across resilience profiles. Enhancing resilience, particularly in low-resilience individuals, may be a potential target for intervention, though causal inference is limited by the cross-sectional design and single-center, convenience sampling strategy. Integrating resilience assessment into clinical evaluation could support more holistic rehabilitation planning. ChiCTR2400089221, September 4, 2024.