Background: A fall experienced by an elderly person is of special note because it appears to hold a reciprocal causal association with the fear of falling. This study attempts to determine the temporal relationship between the fear of falling and falling among community-dwelling elderly.

Methods: Data on falls experienced during the previous three years were obtained from 732 community-dwelling elderly people. Participants were also asked to provide detailed information about their most recent fall, including the date, time of day, place, circumstances, consequences of the fall, fear of falling, and activity limitations due to fear of falling.

Results: Those who had fallen within the past six months had over four times greater odds of a fear of falling and approximately five times greater odds of activity restriction, compared with those who had not fallen. The association decreased linearly over time, and became nonsignificant for those who had not fallen during the past 25–36 months.

Conclusions: The experience of a fall is strongly associated with an increased fear of falling, and the association appears to persist for at least two years. An elderly person who has experienced a fall requires continuous attention to prevent the development of fear as another problem, together with early intervention to counter the fear of falling.