Fall-associated difficulty with activities of daily living in functionally independent individuals aged 65 to 69 in the United States: a cohort study

Abstract

Objectives: To determine whether falling would be a marker for future difficulty with activities of daily (ADLs) that would vary according to fall frequency and associated injury.

Design: Longitudinal analysis.

Setting: Community.

Participants: Nationally representative cohort of 2,020 community-living, functionally independent older adults aged 65 to 69 at baseline followed from 1998 to 2008.

Measurements: ADL difficulty.

Results: Experiencing one fall with injury (odds ratio (OR) = 1.78, 95% confidence interval (CI) = 1.29-2.48), at least two falls without injury (OR = 2.36, 95% CI = 1.80-3.09), or at least two falls with at least one injury (OR = 3.75, 95% CI = 2.55-5.53) in the prior 2 years was independently associated with higher rates of ADL difficulty after adjustment for sociodemographic, behavioral, and clinical covariates.

Conclusion: Falling is an important marker for future ADL difficulty in younger, functionally independent older adults. Individuals who fall frequently or report injury are at highest risk.

Figure 1. The longitudinal progression of the 1998 Health and Retirement Study cohort (no difficulty with activities of daily living or instrumental activities of daily living and aged 65-69 years at baseline; n = 2,120 respondents)