Fall risk and its determinants among home-dwelling older adults: A multivariate logistic regression analysis

Abstract

Objectives: Older adults receiving home healthcare are at increased risk of falls due to environmental, nutritional, psychological, and functional vulnerabilities. Fear of falling (FoF) may further restrict activity and contribute to adverse outcomes. This study aimed to examine factors associated with fall history and FoF using multivariate logistic regression analysis.

Methodology: A cross-sectional study was conducted among 320 older adults (≥65 years) receiving home healthcare at Izmir Bozyaka Training and Research Hospital between November 2023 and January 2024. Data were collected during home visits using validated tools: FRAIL Scale, Malnutrition Universal Screening Tool (MUST), Barthel Index, Itaki Fall Risk Scale, Six-Item Screener, Tinetti Balance and Gait Test, and Geriatric Depression Scale-Short Form (GDS-SF). Fall history and FoF were self-reported. Predictors were identified using multivariate logistic regression models.

Results: The mean age was 81.52±7.57 years; 53.8% were female. Fall history and FoF were reported by 58.8% and 54.4%, respectively. Multivariate logistic regression analysis revealed that fall history was significantly predicted by environmental hazards (OR=37.37), age ≥80 (OR=2.60), high risk on Itaki (OR=12.15) and Tinetti (OR=5.44) scales, malnutrition risk (OR=4.64), and moderate/severe depression (OR=2.58). FoF was significantly associated with obesity (OR=5.84), calf circumference ≤31 cm (OR=3.55), environmental hazards (OR=8.90), malnutrition risk (OR=3.33), and moderate/severe depression (OR=3.66).

Conclusion: Falls and fear of falling in home-dwelling older adults are multifactorial issues predominantly driven by environmental safety and functional mobility. Comprehensive geriatric assessments, focusing on home environment modifications and nutritional support, are essential to reduce fall-related morbidity in this population.