Abstract: Objective To investigate the temporal evolution of fall risk perception and its determinants in patients with osteoporotic fractures. Methods A prospective study design was employed, enrolling 118 patients with osteoporotic fractures admitted between January 2023 and October 2024. Patients were surveyed using the Fall Risk Perception Scale at five time points: at discharge (T0), and at 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-discharge. A latent class growth model (LCGM) was utilized to identify distinct trajectories of fall risk perception scores over time. Subsequently, logistic regression analysis was performed to ascertain the factors influencing these developmental trajectories. Results The mean fall risk perception scores for the 118 patients were (47.66±8.41) at T0, (50.65±8.92 )at T1, (51.50±10.68) at T2, (49.16±12.42) at T3, and (47.33±12.21) at T4. The LCGM analysis identified three distinct trajectories for fall risk perception scores: a "sustained low-risk perception" group (n=34, 28.81%), a "moderate fluctuation" group (n=56, 47.46%), and a "sustained high-risk perception" group (n=28, 23.73%). Ordinal multinomial logistic regression analysis revealed that patients who were younger than 60 years (OR=3.559, 4.311), had an educational attainment of junior high school or higher (OR=3.326, 4.896), reported a history of falls (OR=2.985, 4.180), had no depression (OR=2.888, 2.804), or possessed a good knowledge of osteoporosis (OR=3.286, 4.255) were significantly more likely to belong to the moderate fluctuation or sustained high-risk perception groups (all P<0.05). Conclusion The perception of fall risk among patients with osteoporotic fractures follows distinct temporal trajectories. Age, educational attainment, history of falls, depression, and osteoporosis-related knowledge are significant determinants of these trajectories. Healthcare professionals should consider the specific characteristics of these different trajectory groups to develop tailored, individualized intervention strategies aimed at enhancing patients' perception of fall risk.

Key words: Osteoporotic fractures, Fall risk perception, Latent class growth modeling, Influencing factors, Depression, History of falls