Fall is the leading cause of disability and mortality due to unintentional injury in older adults. The aim of this study was to determine the prevalence and risk factors associated with knee pain, fear of falling, and quality of life among community-dwelling older adults in Northern Thailand. A cross-sectional study was conducted among older adults aged 60 and over. A total of 369 participants were enrolled from April to May 2024. Oxford knee score, a short version of the Falls Efficacy Scale International (FES-I) and World Health Organization quality of life-BREF-Thai, was measured. The results showed that the mean age was 69.4 years and 47 (12.7%) had a history of falls in the previous year. The prevalence of fear of falling was 39.3% for low, 22.5% for moderate, and 38.2% for high concern. Age, marital status, alcohol, history of falls, hypertension, arthritis, and osteoporosis were associated with fear of falling. After adjusting to age, gender, body mass index, education, marital status, smoking, alcohol, history of falls, and chronic disease, osteoarthritis of the knee was positively associated with increasing fear of falling (β: 0.361; p<0.001), while quality of life was negatively associated with fear of falling (β: -0.064; p<0.011). In conclusion, the identified determinants of fear of falling among the elderly indicated the need for fear of falling prevention programs targeting not only individual lifestyles but also chronic diseases. This study provides useful information that might help to develop and adopt effective policies for fear of falling control in Thailand.

Zanthoxylum rhetsa (Roxb.) DC. (Ma-Khwaen) is an economically important medicinal plant traditionally used for pain and inflammatory disorders. This study explored its phytochemical composition, biological activities, and potential for nano-spray product development. Methods: Ethanolic fruit extracts collected from five provinces in Northern Thailand were evaluated for extraction yield, total phenolic content (TPC), total flavonoid content (TFC), antioxidant activity, and anti-inflammatory activity. Extracts from Nan Province were further selected for DPPH radical scavenging, GC–MS characterization, nitric oxide (NO) inhibition assay in LPS stimulated RAW 264.7 macrophages, nano-spray formulation development, and stability assessment. Results: Considerable phytochemical variation was observed among geographical origins, with TPC and TFC ranging from 19.47 to 103.09 mg GAE/g extract and 28.57 to 400.72 mg QE/g extract, respectively. The Nan whole-fruit extract exhibited the highest extraction yield (20.81%), whereas the pericarp extract showed the strongest antioxidant activity (IC₅₀ = 111.78 μg/mL). GC–MS analysis revealed anti-inflammatory phytochemicals, predominantly α-terpineol, geranyl acetate, n-hexadecanoic acid, oleic acid, and linalool. The selected extract demonstrated potent anti-inflammatory activity (IC₅₀ = 6.95 ± 0.44 μg/mL), exceeding that of prednisolone, and was successfully incorporated into a physically stable nano-spray formulation with 60-day storage stability. Conclusions: These findings provide scientific validation for the traditional use of Ma-Khwaen and support its development as a stable nano-spray formulation for muscle pain relief and inflammation alleviation.

Background: Socio-demographic factors, health literacy (HL), and herbal medicine use behaviors are key contributors to improved self-care practices and enhanced quality of life among older adults. We examined the factors associated with herbal medicine use behaviors among elderly individuals in Northern Thailand. Methods: A cross-sectional survey of older persons aged 60 and up was done between April and May 2025, with a total of 382 participants. Socio-demographic factors and herbal medicine use behaviors were assessed using a structured questionnaire. HL was measured using the European Health Literacy Questionnaire (HLS-EU-Q16). Results: The results indicated that the prevalence of herbal medicine use was 67.8%. HL levels were distributed as follows: 60.5% had likely sufficient HL, 21.2% had likely problematic HL, and 18.3% had inadequate HL. In the binary logistic regression analysis, the odds of herbal medicine use were higher among participants aged ≥65 years (OR = 1.71, 95% CI: 1.10–2.65), those without diabetes mellitus (OR = 1.85, 95% CI: 1.09–3.13), individuals with a history of falls in the previous year (OR = 4.47, 95% CI: 1.97–10.13), and those with inadequate HL (OR = 3.12, 95% CI: 1.56–6.27). Conclusions: The findings revealed that participants aged ≥65 years, those without diabetes mellitus, individuals with a history of falls in the previous year, and those with inadequate HL were more likely to use herbal medicine. These results suggest that interventions addressing socio-demographic factors and HL could improve health outcomes related to herbal medicine use in this demographic.