Clinical and Self-Care Factors Associated with Fear-of-Falling Avoidance Behavior in Older Adults with Type 2 Diabetes: A Cross-Sectional Study

Background/Objectives: Fear-of-falling avoidance behavior can restrict mobility and independence among older adults with type 2 diabetes mellitus (T2DM). This study examined associations of diabetes self-care behaviors and selected clinical and fall-related characteristics with fear-of-falling avoidance behavior. Methods: This cross-sectional study included 137 adults aged ≥65 years with T2DM attending Diyarbakır Gazi Yaşargil Training and Research Hospital between November 2023 and April 2024. Data were collected using the Patient Information Form, Fear of Falling Avoidance Behavior Questionnaire (FFABQ), and Summary of Diabetes Self-Care Activities (SDSCA). Correlation analysis and hierarchical stepwise regression were performed, with age and sex entered as prespecified covariates. Additional analyses included a clinically justified simultaneous-entry model and 2000 bootstrap repetitions of the screening and selection procedure. Results: The final stepwise model explained 66.9% of the variance in FFABQ scores (adjusted R2 = 0.653). Higher age (β = 0.432), assistive device use (β = 0.408), diabetic foot (β = 0.235), and longer diabetes treatment duration (β = 0.159) were associated with higher scores, whereas higher SDSCA exercise scores were associated with lower scores (β = −0.246; all p ≤ 0.003). Sex was not significantly associated with FFABQ scores. The simultaneous-entry model yielded similar associations. Bootstrap selection frequencies were 100.0% for assistive device use, 97.80% for exercise, 86.55% for diabetic foot, and 45.05% for treatment duration. Conclusions: These exploratory associations may inform nursing assessment of mobility, diabetic foot status, exercise behavior, and fear-related activity restriction. The association with treatment duration requires particular caution because of selection uncertainty. Longitudinal and experimental studies are needed to clarify temporal relationships and evaluate the efficacy and safety of exercise interventions tailored to foot status and functional capacity.