Multidimensional risk factors for fall experience in Chinese older adults: a qualitative study

Background: Falls have become the leading cause of unintentional injuries among older adults aged 65 years and older in China, and the incidence tends to increase with age. This study aimed to analyze the feelings and experiences of older adults during falls, to identify the key risk factors for falls, and to provide evidence to support the development of prevention strategies. Methods: Using purposive sampling, 26 older adults aged 65 years or older who had experienced a fall in the past year were recruited from Liaocheng District, Shandong Province, China, between March and August 2024 as study participants. We collected data through face-to-face semi-structured interviews and anonymized all participants. Data were analyzed using thematic analysis to distill key themes. Results: A total of 32 fall experiences were reported by the 26 participants. From these fall experiences, the following themes related to fall risks were extracted, ranked from high to low in terms of frequency: environmental factors (23), such as pavement conditions in public spaces and inadequate lighting conditions; physical factors (14), such as physical illnesses and physical adverse symptoms or manifestations; behavioral factors (13), such as excessive speed of steps and inappropriate shoes; psychological factors (6), such as cognitive biases and fear of falling; family support factors (2), mainly manifested as inadequate family support. Furthermore, it was also found that most fall events (18) resulted from the combined effect of multiple factors, highlighting the complexity of the interaction of multiple factors. Conclusion: Falls in old adults are a complex health problem involving multiple factors and levels. To prevent falls effectively, a comprehensive and integrated prevention strategy is necessary.