Is fall self-efficacy an independent predictor of recurrent fall events in older adults? Evidence from a 1-year prospective study.

Falls, which are prevalent among older adults, may not only cause severe physical injuries, but also lead to low fall self-efficacy (FSE). Low FSE is associated with restricted activity, which putatively increases risk of future falls. However, emerging studies have failed to confirm this association. Furthermore, the interplay between age, gender, and fall history with falls has not been adequately addressed in adults aged 70 years or older. The aims of this secondary analysis were to: (1) prospectively explore the association of FSE and fall events considering age, gender, and fall history, and (2) examine the characteristics of fall events and fall-related outcomes. Forty-seven community-dwelling adults over 70 years of age were followed for about 12 months. During the follow-up, 22 participants with low FSE experienced 119 fall events whereas 25 participants with high FSE reported 106 fall events. Among fallers, 72.3% (n = 34) experienced recurrent fall events. About 15.0% (n = 34) of 225 fall events resulted in injuries and 4.0% of injuries required medical care. FSE was a statistically significant predictor of future fall events (incident rate ratio = 0.96, p = .013) regardless of age, gender, and fall history. Participants with low FSE were more likely than those with high FSE to fall more frequently without noticeable prodromal symptoms and apparent reasons. These findings suggest that FSE is an important protective factor against future fall events. However, interpretation of these results requires caution given the small sample size and effect size.