Sex differences and determinants of late-life falls in China: A cross-sectional study based on the CHARLS dataset

Background: As global population aging intensifies, falls among older adults have emerged as a critical public health challenge. While evidence indicates Sex differences in fall rates, few Chinese studies have examined sex-specific risk factors. This study aimed to investigate sex disparities and determinants of falls among Chinese adults aged 45 and above using data from the China Health and Retirement Longitudinal Study (CHARLS). Methods: The research analyzed data on 9,284 participants from the fifth wave of the China Health and Retirement Longitudinal Study (CHARLS). The study investigated the prevalence and associated factors of falls among older individuals, stratified by sex, using logistic regression analysis. Additionally, we examined the interactions between other covariates and sex. Results: The prevalence of falls among the elderly population in China was 20.1%, with 23.12% among women and 14.99% among men (P < 0.001). Age, self-perceived health, mental health, sleep duration, alcohol consumption, social activity, bodily pain and number of chronic diseases were correlated with falls in both sexes (P < 0.05), with no significant interaction (P > 0.050). Age over 80 years and having a chronic disease were significantly associated with falls in men (P < 0.05), but not in women (P = 0.163). The correlation between depression and falls was stronger in females than in males (P < 0.001), inverse in self-perceived health (P < 0.001) group. Females who drank alcohol had an increased prevalence of falls (P < 0.05). Taking part in social activities was correlated with falls in females (P = 0.002), but not in males (P = 0.738). Conclusions: Falls are a serious health issue in China. There is an urgent need for prevention and intervention activities for older individuals, and these needs diverge along sex lines.