Modifiable risk factors for falls in community-dwelling older adults

Background and Objectives: Nearly 30% of U.S. adults aged 65 and older fall each year, and falls are the leading cause of injury and injury-related deaths in this population. Our objective was to identify potentially modifiable risk factors for falls, which will be important in determining the most effective targets for interventions and help refine fall prevention guidelines. Research Design and Methods: Our sample included 3,111 community-dwelling older adults (65 years and older, 57% women) without dementia from the Health and Retirement Study (2010 wave) who reported falls at baseline and 2 years later. We examined the association between reported falls at follow-up and 15 potentially modifiable medical and lifestyle risk factors using logistic regression models, overall and stratified by sex. We calculated the adjusted odds ratio (aOR) and Population Attributable Fraction (PAF) for each risk factor. Results: Falls were reported in 1,027 participants (33%) at follow-up. In females, previous fall history (aOR 2.95), heart conditions (aOR 1.38), and pain (aOR 1.40) predicted incident falls and together accounted for 42% of the PAF for falls. In males, previous fall history (aOR 4.74), poor balance (aOR 1.64), poor hearing (aOR 1.83), and physical inactivity (aOR 1.42) predicted incident falls and together accounted for 52% of the PAF for falls. Discussion and Implications: Several potentially modifiable risk factors were associated with incident falls in older adults and differed by sex. These results are a key initial step in identifying older adults with the highest fall risk and who may most benefit from targeted interventions.