The Worse the Physical Function, the More Probable the Concerns about Falling.

Few studies have explored the impact of poor physical function on concerns about falling (CaF) in older adults, often with low sensitivity due to fragmented assessments. The functional continuum (FC), which covers the full range from robust function to disability, may better capture the relationship between physical function and CaF risk. Using data from NHATS (Rounds 1-10), a proportional hazards model examined CaF risk stratification by FC categories. Among 6,547 participants, 30.1% reported CaF. CaF risk increased progressively with worsening FC, showing a significant dose-response relationship (HR 1.13, 95% CI: 1.10-1.16). While FC categories 2-3 showed no significant difference from category 1, risk increased at category 4 (HR 1.35, 95% CI: 1.11-1.65) and doubled at categories 6-8. CaF risk increases with worsening physical function. FC can complement existing risk tools to identify high-risk older populations and guide the design of targeted interventions to prevent CaF.