Chronic disease count and fall-related characteristics among community-dwelling older adults: a cross-sectional study of recurrent falls and fall timing.

Abstract

Background: Chronic conditions and falls commonly co-occur in older populations. This study described fall occurrence, recurrent falls, and participant-level fall timing across chronic disease count groups in a single-city community sample.

Methods: This cross-sectional survey included 610 community-dwelling adults aged ≥60 years in Neijiang, Sichuan, China. Self-reported falls during the preceding 12 months were classified by occurrence and frequency; recurrent falls were defined as ≥2 falls. One participant-level fall-timing category was analyzed per faller. Chronic disease count was an unweighted sum of seven disease domains. Crude and minimally adjusted logistic regression described count associations. Disease-specific crude associations, post-LASSO models, and an equal-duration morning-versus-afternoon comparison were exploratory analyses.

Results: Overall, 303 participants (49.7%) reported falls and 96 (15.7%) reported recurrent falls. Fall occurrence was non-monotonic across count groups (52.9%, 42.2%, 47.8%, 56.6%, and 68.6% for 0, 1, 2, 3, and ≥4 diseases); corresponding recurrent-fall proportions were 9.6%, 12.9%, 16.5%, 19.7%, and 37.3%. The minimally adjusted OR for recurrent falls in the ≥4 group versus 0 was 4.85 (95% CI 2.06-11.46). The five-category timing distribution did not show clear evidence of an overall difference (Pearson p = 0.195). The morning/non-morning contrast had p = 0.024, and the equal-duration comparison included 203 fallers (108 morning and 95 afternoon; p = 0.011). Disease-specific estimates varied across diseases and outcomes. Post-LASSO findings remained exploratory.

Conclusion: Fall-related characteristics differed across chronic disease count groups in this Neijiang sample, particularly with respect to recurrent falls. Timing differences depended on the comparison used. These cross-sectional findings are hypothesis-generating and do not establish temporal or causal relationships. Prospective, multicenter studies are required.