Multifactorial predictors of falls in older adults: a decade of data from the National Health and Aging Trends Study

Abstract Background Falls are a leading cause of injury and loss of independence among older adults, yet comprehensive, population-level models that integrate diverse risk factors across broad demographic groups remain limited. Prior studies often focus on isolated variables or narrow subpopulations, limiting their generalizability. Methods To address this, we developed a robust, comprehensive model of fall risk among community-dwelling older adults using 11 years of data from the National Health and Aging Trends Study (NHATS), a longitudinal study of older adults in the United States designed to be nationally representative across a wide range of demographic and socioeconomic backgrounds. We conducted a retrospective analysis of 5,816 person-year observations from 2011 to 2022, applying univariate chi-squared tests and multivariable logistic regression to identify features associated with self-reported falls within a given month in the preceding year. Risk factors examined included sociodemographic characteristics, health status, cognitive function, and physical performance. Results Approximately 10% of respondents reported a fall during a specific time within the past year. Consistent features associated with increased fall risk included prior fall history, impaired balance, depressive symptoms, and use of mobility aids. Cross-category analyses revealed important variations in risk profiles by age, functional status and ability to perform certain exercises. Conclusions This study presents a decade-spanning model that reflects the multifactorial nature of fall risk and the diversity of aging trajectories in the U.S., providing a foundation for more inclusive and personalized fall prevention strategies.