Front Public Health. 2026 Jul 6;14:1827109. doi: 10.3389/fpubh.2026.1827109. eCollection 2026.
ABSTRACT
BACKGROUND: Self-awareness of falls is a comprehensive psychological trait encompassing an individual's subjective assessment of their own falls risk, risk identification, and prospective preventive behavioral tendencies. It serves as a key cognitive-behavioral mediating factor influencing the occurrence of falls. Older patients with cardiometabolic multimorbidity face multiple fall-related risks due to advanced age, multimorbidity, and polypharmacy. However, research on self-awareness of falls in this population remains in its early stages, and most existing studies have adopted a variable-centered approach, which fails to capture the potential individual heterogeneity.
METHODS: Using convenience sampling, a total of 363 older patients with cardiometabolic multimorbidity were recruited from six communities in Anhui Province, China, between September and December 2025. Demographic and disease-related information were collected using a general information questionnaire. Assessments were conducted using the following instruments: the Self-awareness of Falls Scale, the STEADI Stay Independent Brochure Questionnaire, the Barthel Index, the Self-Rating Anxiety Scale (SAS), the Multidimensional Scale of Perceived Social Support, and the Pittsburgh Sleep Quality Index. Latent profile analysis was performed using Mplus 8.7 to identify distinct profiles of self-awareness of falls. Univariate analysis and multivariate logistic regression were conducted using SPSS 27.0 to explore factors associated with latent profile membership.
RESULTS: A total of 343 valid questionnaires were collected in this study, yielding an effective response rate of 94.5%. Based on the characteristics of self-awareness of falls in older patients with cardiometabolic multimorbidity, latent profile analysis identified four distinct latent profiles: Low Falls Alertness Profile (Profile 1, n = 82, 23.91%), External Environment-Oriented Falls Alertness Profile (Profile 2, n = 105, 30.61%), Self-Behavior-Oriented Falls Alertness Profile (Profile 3, n = 95, 27.70%), and High Falls Alertness Profile (Profile 4, n = 61, 17.78%). The entropy value was 0.856, indicating good accuracy of the latent profile classification. Multivariate logistic regression analysis revealed that multiple factors were significantly associated with latent profile membership of self-awareness of falls in older patients with cardiometabolic multimorbidity. Specifically, aged 65-74 years and having two chronic diseases were strong positive predictors of the Low Falls Alertness Profile and the Self-Behavior-Oriented Falls Alertness Profile (OR = 3.67-4.18, all p < 0.05). Male gender was an independent positive predictor of the External Environment-Oriented Falls Alertness Profile (OR = 3.109, p < 0.05). Self-rated falls risk score exhibited consistent protective effects across all profiles (OR = 0.323-0.840, all p < 0.05).
CONCLUSION: The level of self-awareness of falls among older patients with cardiometabolic multimorbidity remains at a moderate level. Latent profile analysis identified four distinct subtypes of self-awareness of falls in this population, exhibiting significant heterogeneity. Based on the characteristics of each profile and the differences in influencing factors, clinical nursing practice should move beyond traditional uniform interventions and implement profile-specific assessment and targeted interventions according to different falls alertness subtypes, thereby enhancing the effectiveness of falls prevention.
PMID:42518557 | PMC:PMC13384101 | DOI:10.3389/fpubh.2026.1827109