Impacts of Fear of Falling and Low Physical Activity on the Quality of Life of Community-Dwelling Older Adults

Background and purpose Both fear of falling (FOF) and low physical activity (PA) are prevalent risk factors for falls in an aged society; however, their effects on the quality of life (QoL) remain insufficiently understood. This study aimed to investigate the influence of FOF and low PA on various QoL dimensions. Methods Data were collected from 600 older adults aged 70 years and above through structured questionnaire interviews conducted in 1996 and 1999 in the Hunei community of Kaohsiung, Taiwan. Their QoL was assessed using the SF-36 and World Health Organization Quality of Life (WHOQOL)-BREF instruments, which were administered in the 1999 follow-up only. The relationship between the full-factor combinations of FOF (vs no FOF) and low PA (vs moderate-to-high PA) and each subscale QoL was analyzed using one-way analysis of variance (ANOVA) and further evaluated through multiple linear regression (MLR) models. The models sequentially included the full-factor combinations and other explanatory variables—namely, age, sex, gait maneuverability score, vision, number of comorbidities, Geriatric Depression Scale (GDS) score, Short Portable Mental Status Questionnaire (SPMSQ) score, and fall frequency. Full MLR models were constructed by replacing the full-factor combinations with their multilevel dummy variables. The MLR models for PCS and MCS were further stratified by the full-factor combinations. Results The participants had a mean age of 76.6 years, 49.2% were male, and 20.2% had both FOF and low PA. ANOVA results showed significant cross-combination differences across all QoL subscales ( p  < 0.001). The partial regression coefficients of the full-factor combinations indicated consistent cross-combination trends for each QoL subscale, and gradients for body pain (BP), general health (GH), vitality (VT), and mental health (MH). Conclusion The combined presence of FOF and low PA was associated with broad negative effects on all QoL subscales among community-dwelling older adults. Interventions targeting fall risk reduction and QoL improvement should be implemented concurrently to maximize outcomes.