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Randomized Controlled Trial
. 2023 May:108:104940.
doi: 10.1016/j.archger.2023.104940. Epub 2023 Jan 20.

Factors associated with falls in older adults: A secondary analysis of a 12-month randomized controlled trial

Katherine L Hsieh  1 , Jaime L Speiser  2 , Rebecca H Neiberg  2 , Anthony P Marsh  3 , Janet A Tooze  2 , Denise K Houston  4
Affiliations
Randomized Controlled Trial

Factors associated with falls in older adults: A secondary analysis of a 12-month randomized controlled trial

Katherine L Hsieh et al. Arch Gerontol Geriatr. 2023 May.

Abstract

Purpose: While identifying older adults at risk for falls is important, fall prediction models have had limited success, in part because of a poor understanding of which physical function measures to include. The purpose of this secondary analysis was to determine physical function measures that are associated with future falls in older adults.

Methods: In a 12-month trial comparing Vitamin D3 supplementation versus placebo on neuromuscular function, 124 older adults completed physical function measures at baseline, including the Short Physical Performance Battery (SPPB), Timed Up and Go, tests of leg strength and power, standing balance on a force plate with firm and foam surfaces, and walking over an instrumented walkway. Falls were recorded with monthly diaries over 12 months and categorized as no falls vs. one or more falls. Univariate and multivariable logistic regression adjusting for demographics, treatment assignment, depression, and prescription medications were conducted to examine the association between each physical function measure and future falls. Models were additionally adjusted for fall history.

Results: 61 participants sustained one or more falls. In univariate analysis, white race, depression, fall history, SPPB, and postural stability on foam were significantly associated with future falls. In multivariable analysis, fall history (OR (95% CI): 3.20 (1.42-7.43)), SPPB (0.80 (0.62-1.01)), and postural stability on foam (3.01 (1.18, 8.45)) were each significantly associated with future falls. After adjusting for fall history, only postural stability on foam was significantly associated with falls.

Conclusions: When developing fall prediction models, fall history, the SPPB, and postural stability when standing on foam should be considered.

Keywords: Gait; Logistic regression; Model; Physical function; Physical performance; Postural stability.

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Conflict of interest statement

Declaration of Competing Interest All authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Consort diagram of participants who were included in the study.
Figure 2.
Figure 2.
Association between baseline physical function measures and one or more falls over 12 months of follow-up. Odds ratios (95% confidence intervals). Abbreviations: AP=anteroposterior; ML=medio-lateral; COP=center of pressure
See this image and copyright information in PMC

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