Association Between Fear of Falling–Related Avoidance and Daily Living Activities in Older Adults

INTRODUCTION: This study aimed to evaluate the relationship between fear of falling (FoF)- related avoidance behavior and activities of daily living in older adults.

METHODS: This cross-sectional study was conducted between April and July 2023 with individuals aged 65 years and older who presented to the Family Medicine Outpatient Clinic of a tertiary hospital and met the inclusion criteria for the study. Data were collected using a Descriptive Information Form, the Lawton Instrumental Activities of Daily Living Scale (LIADLS), and the Fear of Falling Avoidance Behavior Questionnaire (FoFABQ).
RESULTS: A total of 317 participants (mean age 71.5 ± 6.1 years) were included. Mean LIADLS and FoFABQ scores were 6.9 ± 1.5 and 10.6 ± 13.0, respectively. LIADLS scores showed a significant negative correlation with FoFABQ (r = –0.42; p<0.001) and age (r = –0.480; p<0.01). FoFABQ scores were positively correlated with age (r = 0.181; p<0.01) and BMI (r = 0.156; p<0.01). Participants with chronic diseases or medication use had higher FoFABQ and lower LIADLS scores (all p<0.001).
DISCUSSION AND CONCLUSION: Based on the distribution of FoFABQ and LIADLS scores, avoidance tendencies appeared generally modest, while functional independence was relatively preserved. Higher avoidance levels were associated with reduced daily living activity performance. Advanced age, higher BMI, chronic diseases, and medication use were also linked with greater avoidance and lower functional capacity. These findings underscore the need for interventions targeting both FoF and functional independence—particularly for older adults with a higher clinical burden.

Keywords: Avoidance behavior, daily living activities, elderly, fear of falling.