Investigating Fall-Related Factors in Community-Dwelling OlderWomen Through Structural Equation Modeling Analysis

Falls are more prevalent in older women than in older men; however, few structural equation analysis studies have focused on the factors contributing to falls in this population, particularly in Asian regions such as Indonesia. This study aimed to investigate the direct and indirect associations among fall-related factors in community-dwelling older women. This cross-sectional study enrolled 90 community-dwelling older women aged ≥ 60 years from August to September 2023. Data collection included structured questionnaires on fall incidence as a sociodemographic variable, fear of falling, and gait efficacy, as well as physical measurements of physical function and the amount of physical activity. Structural equation modeling was used to test the hypothesized pathways among the variables. The results showed that physical function (β = 0.233, p = 0.02), gait efficacy (β = −0.318, p = 0.001), and amount of physical activity (β = −0.243, p = 0.009) were directly associated with fall incidence. Physical function (β = 0.152) and fear of falling (β = 0.183) were indirectly associated with fall incidence through the mediation of gait efficacy and the amount of physical activity. Furthermore, the amount of physical activity was directly associated with high physical function (β = −0.236, p = 0.038). These findings suggest that, in addition to improving physical function and activity levels, older women require psychometric interventions to prevent falls.
Keywords: fall; gait efficacy; older women; physical activity; structural equation modeling