This study aimed to examine the level of falls efficacy and identify its predictors among community-dwelling older adults with ischemic stroke in Wenzhou, China.
A cross-sectional descriptive study was conducted with 335 participants aged 60–75 years, recruited from urban and rural communities in Wenzhou. Data were collected using validated instruments, including the demographic questionnaire, the Short Falls Efficacy Scale-International, the Timed Up and Go Test, the Manual Muscle Testing, the Geriatric Depression Scale (GDS-15), the Physical Activity Scale for the Elderly, the Barthel Index, the Social Support Rating Scale, and the Stroke Stigma Scale. Descriptive statistics and a simultaneous multiple regression analysis were used to analyze the data.
The mean falls efficacy score among 335 community-dwelling older adults with ischemic stroke was 15.70 (SD = 5.37), with 51.9% reporting moderate concern and 48.1% high concern about falling. Multiple regression analysis indicated that activities of daily living (ADL) were the strongest predictor of fall efficacy (β = −0.659, p < 0.001), followed by depression (β = 0.229, p < 0.001) and social support (β = −0.063, p = 0.015). Together, these factors explained 80.3% of the variance in falls efficacy. Balance function, lower limb power, fall history, physical activity, and stroke stigma were not statistically significant in the final model.
Practitioners supporting older stroke survivors in the community should prioritize ADL rehabilitation and routine depression screening, while also actively engaging available social support networks. Community health care providers can use these findings to design multidimensional fall-prevention programs. The GDS-15 is recommended as an accessible tool for detecting depressive symptoms in this population during routine follow-up.
This is one of the first studies to comprehensively examine predictors across multiple domains of the International Classification of Functioning, Disability, and Health framework among community-dwelling older adults with ischemic stroke in China. The findings provide a strong empirical basis for culturally tailored community interventions to improve falls confidence and functional independence in this growing population.
