Northern Thailand Research Articles

Factory Logistics Improvement: A Case Study Analysis of Companies in Northern Thailand, 2022–2024

Background: Thailand’s logistics costs significantly exceed global averages. This study examines the novel application of a triple-helix model in factory logistics improvement projects in Northern Thailand from 2022 to 2024, addressing industrial logistics inefficiencies. Methods: The project involved 30 factories across various sectors, employing a case study methodology to analyze improvement initiatives in transportation, warehouse/inventory management, and logistics administration. Results: Transportation management interventions yielded up to 25% cost savings and improved delivery performance. Warehouse and inventory management upgrades led to inventory cost reductions of up to 55%. Logistics administrative improvements resulted in up to 20% cost savings and enhanced planning capabilities. Conclusions: The project demonstrates the effectiveness of the triple-helix model in facilitating knowledge transfer and practical improvements in industrial logistics. These findings are valuable for Thai industries, policymakers, and logistics managers globally, offering a blueprint for similar initiatives in developing economies. The success of this approach provides practical insights for optimizing logistics operations, potentially benefiting supply chain stakeholders, economic planners, and researchers seeking to enhance logistics efficiency and reduce costs in various industrial contexts.

Factors influencing the third COVID-19 vaccine booster dose acceptance among older adults in northern Thailand

BackgroundCoronavirus disease 2019 (COVID-19) causes more deaths in older adults than in younger adults. Older adults are a vulnerable group with a high need for coronavirus vaccines to decrease the severity of the disease. The aim of this analytical cross-sectional study was to determine the factors influencing third COVID-19 vaccine booster dose acceptance among older adults in northern Thailand.MethodsThe study samples were composed of 2,155 older adults living in Kamphaeng Phet Province, northern Thailand. They were randomly selected by multistage random sampling. Data were collected in a self-administered questionnaire consisting of 7 parts: (1) personal factors, (2) knowledge about COVID-19, (3) perceived susceptibility to COVID-19 infection, (4) perceived severity of COVID-19, (5) perceived benefits of the third COVID-19 vaccine booster dose, (6) perceived barriers to the third COVID-19 vaccine booster dose vaccination, and (7) the third COVID-19 vaccine booster dose acceptance. Data were analyzed via frequency, percentage, mean, standard deviation, and binary logistic regression. All the significance levels were set to 0.05.ResultsThe results indicated that only 28.5% of older adults accepted the third COVID-19 vaccine booster dose. The factors influencing third COVID-19 vaccine booster dose acceptance among older adults included 5 variables. The participants aged ≥ 70 years was 1.37 times (95%CI = 1.12–1.69) greater than those aged < 70 years who accepted the vaccine. Participants who were married were more likely to accept the vaccine by 1.39 times (95%CI = 1.09–1.79) compared with single individuals. Those with underlying diseases tended to accept the vaccine by 1.56 times (95%CI = 1.26–1.92) more than those without underlying diseases. Those who had high perceived benefit from the COVID-19 vaccine possibly accepted the vaccine by 1.50 times (95%CI = 1.10–2.04) more than those with low perceived benefit, and those who had a low perceived barrier to the third COVID-19 booster dose vaccination seemed to accept the vaccine by 1.29 times (95%CI = 1.01–1.52) more than those with a high perceived benefit.ConclusionOlder adults should receive health education regarding the perceived benefit of the COVID-19 vaccine and the perceived barrier to COVID-19 vaccination, especially older adults aged < 70 years, those who are single, and those who are free of underlying diseases.

Diseases, drugs and dust

From 1 January to 20 June 2024, there were 186,900 reported flu cases resulting in 14 deaths in various regions of Thailand and on 21 August 2024 Thailand confirmed the first case of a new lethal variant of mpox. Thailand's Ministry of Public Health has announced plans to reclassify cannabis and hemp as illegal narcotics starting 1 January 2025. Vaping bans were emphasized on 31 May, the World No Tobacco Day. The organized Lung Cancer Screening program was started in the Northern Thailand where the prevalence of lung cancer and the level of PM 2.5 were high.

Latent class analysis of polysubstance use and association of various risk factors with polysubstance use among vocational students in Northern Thailand by sex differences and factors association

Latent class analysis of polysubstance use and association of various risk factors with polysubstance use among vocational students in Northern Thailand by sex differences and factors association

Gastrointestinal Helminthic Infection among the Population in Northern Thailand.

Gastrointestinal (GI) helminthic infections pose substantial public health threat, particularly in northern Thailand, with a heightened concern in Nan province. This study aims to evaluate the prevalence of GI helminthic infections in Nan province and identify associated risk factors in local population. A cross-sectional survey was conducted in 2022. Fecal specimens were collected and examined using Kato-Katz technique and Formalin Ethyl-Acetate Concentration Technique (FECT). Univariate analysis employed the Chi-square test to explore correlations, while logistic regression was defined risk factors associated with parasite infections. Among 739 individuals surveyed, 14.34% were revealed GI helminthic infections. Notably, infection rates were higher in males (20.40%) compared to females (8.95%), with a notable prevalence among individuals aged ≥ 60 (17.78%) and high infection rate was demonstrated in Kiew Chan village (21.67%). The most commonly detected helminths were minute intestinal flukes (MIFs) (10.01%) and Capillaria spp. (3.11%). Males were significantly associated with GI helminthic infections, while individuals aged 40-49 and aged 50-59 commonly displayed of parasite infections. Additionally, Kiew Chan village exhibited a significant association with GI helminthic infections, followed by Sop Puen village. Furthermore, fecal specimens of 13 rodent specimens were frequency revealed Strongyloides spp. (92.30%) and mostly exposed Ancylostoma caninum (41.93%) among 93 canines. These findings highlight the imperative for immediate public health interventions in Nan province and analogous areas in northern Thailand. Implementing strategies to enhance sanitation infrastructure and promote hygiene education can significantly contribute for reducing the prevalence of GI helminthic infections and improve overall community health.

Agricultural Health and Safety: Evaluating Farmers’ Knowledge, Attitude, and Safety Behavior in Northern Thailand

BackgroundAgriculture is vital for economic growth and livelihoods in northern Thailand, yet it is challenged by hazardous practices such as improper chemical use and machinery accidents. This study aimed to evaluate the risk and determine the relationship between pesticide exposure and knowledge, attitudes, and safety behaviors. MethodsThis cross-sectional study was conducted between October and December 2017 in the San Pa Tong district of Chiang Mai, Thailand. Data were collected through structured questionnaires and face-to-face interviews with 280 farmers. ResultsThe findings indicated that knowledge and safety behavior scores varied significantly with educational attainment and training received. Farmers with higher education levels or those who had undergone training exhibited better knowledge and safer behavioral practices, whereas income levels did not significantly affect knowledge or safety behaviors. The pesticide exposure risk level was associated with the study variables, with those recognizing a ‘normal’ risk level demonstrating greater knowledge and safer behaviors than those who reported the risk level as safe or at risk. A strong positive correlation between knowledge and safety behavior was observed, indicating that increased awareness can result in more cautious practices. These findings suggest that educational and training programs are crucial for promoting safer pesticide use among farmers. Although attitudes toward pesticide safety varied based on income, education, and training positively influenced knowledge and behavior. ConclusionThe study concludes that understanding farmers’ perceptions of pesticide risks is essential for designing and implementing effective educational interventions.

Morpho-molecular characterization of phoma-like fungi from Morus alba in northern Thailand; a novel species (Boeremia albae) and a new host record (B. maritima)

Boeremia was established to accommodate phoma-resembling fungi. Its species occur in terrestrial ecosystems as endophytes, saprobes and pathogens, except one species reported from a marine ecosystem. Boeremia species are characterized by hyaline, thin-walled, and aseptate (occasionally 1(–2)-septate) conidia that are variable in shape, and hyaline, straight or slightly curved, thick-walled, and 1-septate ascospores that are usually constricted at the septum. In the past, host associations were used to delimit Boeremia species. However, since Boeremia taxa have overlapping morphological characters and are cryptic, it renders taxonomic identification arduous. Therefore, the use of other approaches including multi-gene phylogenetic analyses are imperative. Recommended DNA markers for species delineation are the internal transcribed spacer (ITS, nuclear rDNA consisting of ITS1-5.8S-ITS2) and large subunit (28S, D1–D2 domains of nuclear 28S rDNA) loci, and the genes for actin (ACT1), beta-tubulin (TBB1), RNA polymerase 2 (RPB2) and translation elongation factor 1α (TEF1). Here, we applied morphological and molecular phylogenetic analyses to establish a new taxon (B. albae), and a new host and geographical record for B. maritima associated with leaf spots of Morus alba (Moraceae) in northern Thailand. By providing sequence data for three additional gene regions, our phylogenetic analyses impart a stable phylogenetic placement of the ex-type strain of B. maritima, as illustrated. This is the first study that reports Boeremia species from M. alba, and B. maritima from a terrestrial habitat.

Mental health, fall prevention behaviors, and home environments related to fall experiences among older adults from ethnic groups in rural Northern Thailand

Accidental falls pose significant threats to older adults' health and safety. This study investigates the associations between mental health, fall prevention behaviors, home environments, and yearly falls among older adults of various ethnicities. Conducted in rural ethnic areas of two provinces in northern Thailand, this cross-sectional study utilized multi-stage sampling to survey 462 older adults aged 60 and above, including Mien, Hmong, Karens, and indigenous people. Participants self-reported their history of accidental falls and provided mental health (GHQ-28) data. Univariate logistic regression highlighted associations between falls and mental health problems (OR = 14.87, 95%CI = 7.51–29.43) and the score of fall prevention behaviors (OR = 0.37, 95%CI = 0.31–0.45). Home environment factors, including floor type, floor risk factors, and stair safety features, were significantly related to falls (p < .05). Multivariable analysis identified gender, financial status, underlying disease, vision impairment, mental health problems, and fall prevention behaviors as independent predictors of past-year falls among ethnic older adults (p < .05), explaining 84.7 % of the variation in log odds of falling. This study underscores the heightened fall risks among ethnic minority older adults with mental health issues while emphasizing the protective role of fall prevention behaviors.

On the status of the genus-group name Cragandhara Volynkin with description of a new species from Thailand and Laos (Lepidoptera: Erebidae: Arctiinae: Lithosiini)

The recently described genus Cragandhara Volynkin, 2023 is downgraded to subgenus of the genus Gandhara Moore, 1878. A new species, Gandhara (Cragandhara) riparia Volynkin &amp; Černý, sp. n. is described from Northern Thailand and Northern Laos. Two new combinations are introduced: Gandhara (Cragandhara) himalaya (Volynkin, 2023), comb. n. and Gandhara (Cragandhara) khasia (Volynkin, 2023), comb. n. The hitherto unknown female of G. (C.) khasia is illustrated and diagnosed. The complete checklist of the genus Gandhara is provided. Adults as well as male and female genitalia are illustrated.

External validation of the CARDOT score for predicting respiratory complications after thoracic surgery

BackgroundThe CARDOT scores have been developed for prediction of respiratory complications after thoracic surgery. This study aimed to externally validate the CARDOT score and assess the predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) for postoperative respiratory complication.MethodsA retrospective cohort study of consecutive thoracic surgical patients at a single tertiary hospital in northern Thailand was conducted. The development and validation datasets were collected between 2006 and 2012 and from 2015 to 2021, respectively. Six prespecified predictive factors were identified, and formed a predictive score, the CARDOT score (chronic obstructive pulmonary disease, American Society of Anesthesiologists physical status, right-sided operation, duration of surgery, preoperative oxygen saturation on room air, thoracotomy), was calculated. The performance of the CARDOT score was evaluated in terms of discrimination by using the area under the receiver operating characteristic (AuROC) curve and calibration.ResultsThere were 1086 and 1645 patients included in the development and validation datasets. The incidence of respiratory complications was 15.7% (171 of 1086) and 22.5% (370 of 1645) in the development and validation datasets, respectively. The CARDOT score had good discriminative ability for both the development and validation datasets (AuROC 0.789 (95% CI 0.753–0.827) and 0.758 (95% CI 0.730–0.787), respectively). The CARDOT score showed good calibration in both datasets. A high NLR (≥ 4.5) significantly increased the risk of respiratory complications after thoracic surgery (P < 0.001). The AuROC curve of the validation cohort increased to 0.775 (95% CI 0.750–0.800) when the score was combined with a high NLR. The AuROC of the CARDOT score with the NLR showed significantly greater discrimination power than that of the CARDOT score alone (P = 0.008).ConclusionsThe CARDOT score showed a good discriminative performance in the external validation dataset. An addition of a high NLR significantly increases the predictive performance of CARDOT score. The utility of this score is valuable in settings with limited access to preoperative pulmonary function testing.

Buserelin Acetate Added to Boar Semen Enhances Litter Size in Gilts in Tropical Environments.

The use of exogenous hormones has long been of interest for improving reproductive performance in swine production. Enhancing litter size directly impacts the economic efficiency of pig production. Various strategies, including nutritional, genetic, and hormonal approaches, have been explored with varying degrees of success. Administering a gonadotropin-releasing hormone (GnRH) agonist, such as buserelin, at the onset of estrus can induce ovulation and reduce the variation in ovulation timing among sows. This study assessed the impact of GnRH agonist supplementation in boar semen doses on the litter size of inseminated gilts. The research was conducted on a commercial swine herd in northern Thailand. A total of 231 Landrace × Yorkshire crossbred gilts, aged 224.5 ± 16.2 days at the onset of estrus synchronization, participated in the experiment. The gilts' estrus was synchronized with oral altrenogest supplementation at a dosage of 20 mg/day for 18 days. After exhibiting standing estrus, the gilts were randomly divided into three groups. Control group: gilts were inseminated at 0 and 12 h post standing estrus onset with a conventional semen dose (n = 94). Treatment 1: similar to the control group, but with an added 5 µg (1.25 mL) of buserelin acetate to the boar semen dose during the first insemination (n = 71). Treatment 2: similar to the control group, but with 10 µg (2.5 mL) of buserelin acetate added to the boar semen dose during the first insemination (n = 66). All gilts were inseminated twice during their standing estrus using the intrauterine artificial insemination method. Each semen dose contained 3.0 × 109 motile sperm in 80 mL. The farrowing rate averaged 78.8% and did not significantly differ between the groups (p = 0.141). The total number of piglets born per litter in the treatment 2 group was greater than in the control group (14.0 ± 0.3 vs. 13.2 ± 0.3, respectively, p = 0.049), but was not significantly different from the treatment 1 group (13.3 ± 0.3, p = 0.154). Similarly, the number of live-born piglets in the treatment 2 group was greater than in the control and treatment 1 groups (13.2 ± 0.4 vs. 12.3 ± 0.3 and 12.0 ± 0.4, respectively, p < 0.05). Moreover, the live-born piglets' litter birth weight in the treatment 2 group was greater than in the control group (17.0 ± 0.4 vs. 15.6 ± 0.3 kg, respectively, p = 0.008) and the treatment 1 group (15.7 ± 0.4 kg, p = 0.025). In conclusion, adding a GnRH agonist to boar semen appears to enhance the litter size of gilts. Further research should focus on understanding the underlying mechanisms and determining the optimal dose and timing for GnRH agonist supplementation.

Siam folk tune “Lanna” for string orchestra

This article discusses the compositional materials and process of “Lanna” for string orchestra based on folk tunes from Northern Thailand (Lanna). The composition comprises 6 movements for a duration of 50 minutes. The composer carefully selected folk tunes and rendered a balance between the borrowed ones and the newly composed materials through the careful mix of musical elements, including keys, melodies, rhythmic patterns, idioms, and re-created the sound to imitate the performance techniques of the original instruments. Certain Western compositional techniques were adapted to fit the original melodies in order to retain the identity of the work and provide a balanced blend of the original Eastern and the new Western melodies, thereby creating a new perspective of sound as well as an inspiration for other composers to continue crafting music in this genre. Traditional Lanna tunes, including Fon Phang, Pan Fai, Noi Chai Ya, and Lao Duang Dokmai are presented partly in multi movements to convey traditional melodies. Imitations of certain singing and playing techniques are also transcribed via selections of instruments in the ensemble, especially the violin solo, to portray both the authentic Lanna atmosphere and the blend of the two cultures.

Study of the population genetic structure of Opisthorchis-like eggs in northern Thailand using mitochondrial genes.

Opisthorchis-like eggs are a public health problem in northern and northeastern Thailand. However, the genetic epidemiology and structure of these parasites in northern Thailand are unknown. Thus, this study investigated their population genetic structure using cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase subunit 1 (nad1) nucleotide sequences. A study was conducted in the hill tribe regions of Chiang Mai Province, northern Thailand. Internal transcribed spacer 2 polymerase chain reaction and restriction fragment length polymorphism were used to distinguish 205 positive feces samples for Opisthorchis-like eggs. The results showed that the prevalence of O. viverrini and Haplorchis taichui was 10.5% and 38.2%, respectively, and the co-infection rate was 37.2%. To determine the genetic structure of O. viverrini and H. taichui using cox1 and nad1 genes, genetic analysis was performed using 30 randomly chosen fecal samples for Opisthorchis-like eggs. Pairwise FST analysis indicated that O. viverrini and H. taichui displayed nonsignificant genetic differentiation within Chiang Mai Province and between interpopulations from different geographic areas. Moreover, within the intrapopulation in Chiang Mai Province,cox1 presented higher gene flow than nad1 in O. viverrini, while nad1 demonstrated higher gene flow than cox1 in H. taichui. The neutrality tests based on Fu's Fs indicated population expansion and selective sweep from bottleneck or hitchhiking in O. viverrini and H. taichui populations, supported by haplotype network patterns. Phylogenetic tree analysis based on cox1 and nad1 revealed the monophyly of O. viverrini and H. taichui and genetic relationships with other isolates collected from Thailand, Lao People's Democratic Republic (PDR), and Vietnam. This study investigated the molecular discrimination and genetic structure of Opisthorchis-like eggs in northern Thailand. The genetic information derived from this study could be associated with the background, molecular epidemiology, and disease severity of these parasites.

Caregivers’ Perspectives About Health and Psychosocial Wellbeing of Next Generation of Hill Tribe Children in Institutional Care in Northern Thailand: A Descriptive Qualitative Study

ABSTRACT Children who grow up in institutional care are usually separated from their families. Separation from families can have lasting negative effects on the physical, cognitive and emotional development of these children. The study aimed to explore the perspectives of caregivers about the health and psychosocial wellbeing of the new generation of Hill Tribe Children in institutional care. Data collection involves both focus group interviews and in-depth one-to-one interviews. Thematic analysis was applied to derive key themes from the data. Four themes emerged from the analysis, namely, (1) Persistent health problems, including lice, scabies, and dental caries; (2) Challenging emotional and behavioral expressions of Generation Z children, including physical and verbal aggression, emotional suppression, and fading social and cultural etiquette; (3) Tensions between discipline and children “s rights; and (4) Emotional fulfillment accompanied by exhaustion. Caregivers” perspectives highlighted the challenges of working with Hill Tribe children. Further training may be needed to manage the balance between addressing the evolving needs of a new generation of Hill Tribe children and preserving their cultural background.

Genetic variability of 23 autosomal STRs in Austroasiatic-speaking populations from Thailand.

Austroasiatic (AA) speakers constitute around 4% of the population of Thailand, while the majority (89.4%) speak Kra-Dai (KD) languages. Previous forensic and population genetic studies in various Thai populations have employed a limited number of short tandem repeats (STRs). This study aims to expand the investigation of the genetic makeup of AA populations in Thailand and their relationship to KD populations using a larger number of autosomal STRs with the VeriFiler™ Plus PCR Amplification Kit. We generated 593 new genotypes from AA-speaking groups and combined them with previously reported data from AA and KD groups. A total of 1,129 genotypes across 23 STR loci were used to construct the largest allelic frequency profile for Thai and Lao populations. However, several loci deviated from Hardy-Weinberg equilibrium, likely due to the reduced genetic diversity in some highland populations, which should be considered in forensic investigations. Beyond forensic applications, our findings reveal genetic differences between AA-speaking groups in Northern and Northeastern Thailand. The AA groups from Northeastern Thailand exhibit greater genetic homogeneity and diversity, likely due to population interactions. In contrast, reduced diversity and increased heterogeneity in AA groups from Northern Thailand are possibly driven by genetic drift and cultural and geographic isolation. In conclusion, we emphasize the usefulness of increasing the number of autosomal STRs in forensic and anthropological genetic studies. Additional Y-STR and X-STR data from various AA-speaking groups in Thailand would further enhance and strengthen forensic STR databases in the region.

BEYOND MEDICINE AVAILABILITY: UNPACKING THE CHALLENGES OF METHADONE MAINTENANCE THERAPY IMPLEMENTATION IN NORTHERN THAI HOSPITALS

Methadone maintenance therapy (MMT) is a harm reduction-based approach that has been part of national policies since 2018. Despite its inception, MMT provision faces challenges, particularly in North Thailand, where opioid use disorders are the most prevalent. This study assessed MMT provisions in terms of system input, performance, and output in all 147 public hospitals under the Ministry of Public Health in Northern Thailand. This cross-sectional study employed an online questionnaire based on the World Health Organization’s six building blocks and the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. Northern Thailand data collection spanned from September 1, 2022, to February 1, 2023. The results revealed that ninety-eight hospitals (66.70%) responded. Only 37.76% actively provided MMT, 4.08% discontinued it, and 58.16% did not offer it. In areas where opioid overuse disorder is reported, MMT is available in 70.59% of the hospitals. The strong system governance and value proposition of MMT in hospitals with MMT services helped 78.49% of patients with opioid use disorder access services and maintained a one-year retention rate of 71.35%. Though patients with MMT services had a high retention rate, gaps still existed such as a lack of staff and training, limited data collection, and insufficient collaboration with stakeholders to expand the referral capacity. Inactive and pending hospitals lacked an MMT service policy, hindering service launches. According to the findings, the scaling up of MMT services still faces challenges, including the fact that most hospitals do not offer these services and even those that do often lack staff, training, and resources. Support for MMT services must be tailored to the specific needs and contexts of different hospitals.

Knowledge, Preparedness, and Practices of Lanna People for Earthquake-Resistant Housing in Active Fault Zones of Northern Thailand

An earthquake shakes the earth’s surface, causing structural damage to buildings, houses, bridges, and highways. Analyzing the earthquake resistance of buildings and Lanna traditional houses in Northern Thailand's active fault zones can mitigate these consequences. This study aimed to: 1) assess the earthquake resistance of buildings and Lanna traditional houses in these zones, and 2) examine the knowledge, preparedness, and practices of Lanna people regarding earthquake-resistant housing. The results revealed that 1.80% of buildings and Lanna traditional houses were not strong enough to withstand earthquakes. However, Lanna people in active fault zones demonstrated a high level of knowledge, preparedness, and practice in earthquake-resistant housing. Lanna traditional houses often use locally available materials like wood, leaves, stone, and bamboo, which are flexible and resilient during earthquakes. These materials are more sustainable than modern construction materials due to their lower environmental impact and cost-effectiveness. Engineers play a crucial role in ensuring homes are earthquake-resistant while preserving the cultural and historical essence of Lanna Thai architecture. By integrating modern engineering practices with traditional design elements, they create homes that are both safe and culturally significant.

Impact of Increment Coring on Growth and Mortality across Various Size Classes of Khasi Pine (Pinus kesiya) in Northern Thailand

Impact of Increment Coring on Growth and Mortality across Various Size Classes of Khasi Pine (Pinus kesiya) in Northern Thailand

Prevalence and Screening of Hypertension Among Schoolchildren in Phitsanulok, Lower Northern Thailand

Prevalence and Screening of Hypertension Among Schoolchildren in Phitsanulok, Lower Northern Thailand

Study of knee pain, fear of falling, and quality of life among community-dwelling older adults, Northern Thailand.

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.