Do Men and Women Have Different Risk Factors for Falls?

Long- and short-term factors associated with fall risk in older adults vary based on sex, according to recent research published in the Journal of the American Geriatrics Society. 

The study included 3,112 adults (1,981 female [mean age 75.2 years], 1,131 male [mean age 71.5]), all aged 60 years and older. Two follow-up periods were studied: short-term (<4 years) and long-term (4-10 years). Researchers defined an injurious fall as one that resulted in inpatient or outpatient care. 

Short-term risk factors independently associated with injurious falls in women included living alone (hazard ratio [HR]=1.83, 95% confidence interval [CI]=1.13–2.96), dependency in instrumental activities of daily living (IADLs) (HR=2.59, 95% CI=1.73–3.87), and previous falls (HR=1.71, 95% CI=1.08–2.72). In men, previous falls was also independently associated with short-term risk of injurious falls (HR=2.81, 95% CI=1.32–5.97); other short-term risk factors for men were low systolic blood pressure (HR=1.96, 95% CI=1.04–3.71) and the inability to rise from a chair (HR=3.00, 95% CI=1.52–5.93). 

For women, long-term risk factors included underweight (HR=2.03, 95% CI=1.40–2.95), cognitive impairment (HR=1.49, 95% CI=1.08–2.06), fall‐risk increasing drugs (HR=1.67, 95% CI=1.27–2.20 for ≥2 drugs), and independent ADL (IADL) dependency (HR=1.58, 95% CI=1.32–5.97). Long-term risk factors observed in men included smoking (HR=1.71, 95% CI=1.03–2.84), heart disease (HR=2.20, 95% CI=1.5–3.24), impaired balance (HR=1.68, 95% CI=1.08–2.62), and a previous fall (HR=3.61, 95% CI=1.98–6.61). 

Lead author Stina Ek, of the Karolinska Institutet in Sweden, said that while studies pertaining to risk factor profiles have been published before, few evaluate sex-related differences. In their paper the researchers wrote that, to their knowledge, theirs is “the first large‐scale prospective cohort study to examine sex‐specific risk factors for injurious falls over different lengths of follow‐up.” 

According to Ek, “The results of our study suggest that men and women have different fall risk profiles. If we take these sex differences into consideration in screening and prevention programs for falls, we may potentially enable a better person-centered approach.” 

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Sources: Wiley, Journal of the American Geriatrics Society