Abstract
BACKGROUNDS: Fear of falling (FoF) is characterized by persistent concerns about falling, and empirical investigations are needed to examine the influence of perceived FoF on the broader and more active dimensions of social functioning. This study aims to explore the association between FoF and social participation in older adults, as well as the effects of changes in status over time. METHODS: This longitudinal panel study analyzed data from eight waves (2006-2020) of the Korean Longitudinal Study of Aging, comprising 8,632 participants aged 60 years and older (3,735 males and 4,897 females). FoF and activity restriction were assessed, with social engagement defined as involvement in at least one formal social activity, and the frequency of participation was also measured. Additionally, these statuses were categorized to reflect changes from the previous wave. Generalized estimating equation models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Over a mean follow-up period of 8.94 years, the average level of social engagement, accounting for variations across all waves, was 73.1% among males and 66.5% among females. Compared to the no FoF group, individuals who had FoF exhibited significantly lower likelihoods of engaging in formal social activity in males (OR: 0.77, CI: 0.67-0.87) and females (OR: 0.84, CI: 0.75-0.94), while those with both FoF and activity restriction exhibited even lower odds of engagement (males, OR: 0.53, CI: 0.44-0.63; females, OR: 0.72, CI: 0.63-0.83). Additionally, FoF is associated with a tendency to impede newly initiated or ongoing social engagements, with more pronounced effects observed in individuals who reported persistent FoF over time. CONCLUSIONS: FoF is associated with reduced social engagement in older adults, and therefore, individuals with FoF may require special attention to prevent negative health outcomes resulting from social isolation caused by FoF.