Characteristics of fall recurrence among persistent, quasi-persistent, and transient fallers: a 3-year analysis from the SCOPE study.

Abstract

Methods: To address the substantial disability and healthcare burden associated with falls in older adults, the aim of this study is to use a new 3-year operationalization of fall occurrence profiles to identify factors linked with persistent falling. Data were obtained from the multicenter SCOPE study, which followed 2461 community-dwelling adults (median age 80.0 and IQR 6.0; 56.1% women) across seven European countries, with assessments at baseline and after 1 and 2 years. Variables included demographics, comorbidities, medication use, functional status, mood, quality of life, and kidney function. Fall-related data included number, location, cause, and consequences. Participants were classified as Persistent-Fallers (falls at all three timepoints), Quasi Persistent-Fallers (falls in two), and Transient-Fallers (one fall episode). Logistic regression assessed predictors of being Persistent-Fallers vs. Transient-Fallers, and vs. Quasi Persistent-Fallers.

Results: Across the study, 894 falls occurred in Persistent-Fallers (n = 137), 919 in Quasi-Persistent Fallers (n = 299), and 695 in Transient-Fallers (n = 524). Most falls occur outdoors and during ambulation. Persistent-Fallers showed poorer physical performance, worse health, and higher proportion of indoor falls. Transient-Fallers were more likely to fall outdoors but sustain a higher risk of fractures per fall. Quasi-Persistent Fallers displayed intermediate characteristics. In fully adjusted models, higher comorbidity burden, presence of lower urinary tract symptoms and poorer self-rated health were significantly associated with persistent falling.

Conclusions: This study reveals distinct faller profiles. Persistent-Fallers reflect frailty and linked to overall medical burden and functional decline; Transient-Fallers are generally healthier, fall outdoors more often, and their falls more often lead to fractures, possibly due to lower risk awareness falls; Quasi-Persistent Fallers exhibit characteristics that fall between those of the other two groups.