Fear of falling, multimorbidity, and social participation among older adults in Primary Health Care

Introduction: Fear of falling is common among older adults and is linked to adverse outcomes, including activity restriction, reduced autonomy, and poorer quality of life. Its management is challenging due to the high burden of multimorbidity, which can heighten perceptions of vulnerability and increase fear of falling, affecting social participation. The objective was to investigate relationships between fear of falling, multimorbidity, and social participation among older adults in Primary Health Care.

Methods: Study was conducted with 175 older adults evaluated in primary care services in a Brazilian city. Participants were asked about fear of falling (yes or no). Morbidities included self-reported of diagnosed health condition. Social participation was assessed using the Mobility-Related Activities and Participation Profile (PAPM), composed of 18 items scored from 0 to 4, scores ranging from 0 to 74. Descriptive analyses, Student’s t-tests, and logistic and linear regressions were performed, with a significance level of 5%. The project received ethical approval.

Results: The mean age of participants was 66.8±8.9 years; 84% were women; and 75.1% reported fear of falling. The mean number of morbidities was 2.4±1.6, and the mean social participation score was 6.4±9.6. The number of morbidities and the level of difficulty in social participation were higher among participants who reported fear of falling. Having more morbidities was associated with a greater likelihood of reporting fear of falling (OR:)0.76;CI:0.59–0.98). Fear of falling (β: –5.61; CI:–8.6 to –2.2) and the number of morbidities (β: 0.39; CI: 0.45–2.32) were associated with lower participation.

Conclusion: Fear of falling is associated with a higher number of morbidities and with greater difficulties in social participation among older adults. Both fear of falling and the number of morbidities were significant predictors of lower participation, highlighting the need for integrated care approaches that simultaneously address physical, emotional, and social factors.