Falls, Injuries, and Health-Related Quality of Life in Older Adults: Evidence from Population-Based Studies

Abstract Falls are a leading cause of morbidity, disability, and mortality among older adults and have substantial implications for health-related quality of life (HRQoL). This study investigated the associations between fall history, injury experience, and HRQoL in older Korean adults, incorporating both physical and cognitive determinants. Using data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative sample of 1,742 participants aged 65 years and older was analyzed. HRQoL was assessed with the EQ-5D-5L index and EQ-VAS. Independent variables included fall history, injury-related hospitalization, handgrip strength (HGS), chronic disease burden, Mini-Mental State Examination (MMSE) scores, and sociodemographic covariates. Weighted regression models were employed to account for complex sampling. Results showed that participants with a history of falls had significantly lower EQ-5D-5L (β = −0.048, p < 0.01) and EQ-VAS scores (β = −4.52, p < 0.001), with fall-related hospitalization producing the most pronounced HRQoL reductions. Lower HGS and poorer cognitive function independently predicted impaired HRQoL. Subgroup analyses revealed that women and those with three or more chronic conditions were disproportionately vulnerable, exhibiting the steepest declines in HRQoL. These findings underscore the multifactorial nature of falls and their impact on older adults’ well-being, highlighting the need for integrated interventions that strengthen physical and cognitive function, address sex-specific and comorbidity-related vulnerabilities, and promote safe home environments.