BMI Status, Balance Impairment, and Fear of Falling Among Older Adults in Rural Northern Thailand

Fear of falling is a prevalent concern among older adults and is associated with physical inactivity, reduced independence, and decreased quality of life. Although various factors contribute to the fear of falling, limited evidence exists regarding the relationship between body mass index status, balance impairment, and fear of falling, particularly in rural populations.

This study aimed to examine the association between body mass index, balance impairment, and fear of falling among community-dwelling older adults in a rural area.

A cross-sectional study was conducted among 439 older adults aged 60 years and above residing in rural Thailand. In the initial phase, a list of older adults was obtained from primary care center records, and simple random sampling was employed to select participants according to the inclusion criteria. Data were collected on demographic characteristics, body mass index, balanced performance (measured using the Berg Balance Scale and the Timed Up and Go test), and fear of falling (assessed using the Short Falls Efficacy Scale-International). Multiple linear regression analysis was conducted to determine the factors significantly associated with fear of falling.

The results showed that 56.7%, 18.5%, and 24.8% of the elderly had low, moderate, and high fear of falling, respectively. Multiple regression analysis revealed that balance performance, as measured by the Berg Balance Scale, was the only significant predictor of fear of falling (β = –0.298, p < 0.001), whereas the Timed Up and Go test and body mass index were not significantly associated.

Balance impairment is a key determinant of fear of falling among older adults in rural areas. Interventions to improve balance may be effective in reducing fear of falling and preventing functional decline in this population.