Distinct factors associated with past-year fall occurrence and fall-related injury among community-dwelling older adults: a cross-sectional analysis

Background Current fall prevention strategies have been built predominantly on the factors associated with fall occurrence rather than fall-related injury, and the determinants of these two outcomes may be distinct. This study aimed to identify distinct factors associated with past-year fall occurrence (non-fallers vs. fallers) and fall-related injury (non-injurious vs. injurious fallers) in community-dwelling older adults. Methods In this cross-sectional, secondary analysis, 9,950 community-dwelling older adults were included (mean age 74.0 years, standard deviation 6.8, 61.6% women). Binomial logistic regression was used to separately identify the associated factors for fall occurrence and fall-related injury, assessing demographics, chronic diseases, functional abilities, and home modifications. Results Past-year fall occurrence was primarily associated with women (odds ratio (OR) = 1.66, 95% confidence interval (CI): 1.19–2.30), drinking (OR = 1.43, 95% CI: 1.03–1.99), higher number of chronic diseases (OR = 1.3, 95% CI: 1.24–1.36), assistive devices usage (OR = 1.3, 95% CI: 1.19–1.43), and activities of daily living (ADL) limitations (OR = 1.07, 95% CI: 1.04–1.11). In contrast, fall-related injury was associated with younger age (OR = 0.96, 95% CI: 0.93–0.99), lower weight (OR = 0.97, 95% CI: 0.95–0.996), lower number of assistive devices (OR = 0.82, 95% CI: 0.68–0.98), and higher number of ADL limitations (OR = 1.07, 95% CI: 1.01–1.13). Notably, home modifications were not associated with lower odds of either outcome ( p > 0.05). Conclusions Our study highlights distinct differences between the associated factors for past-year fall occurrence and fall-related injury. The inverse association for assistive devices should not be read as evidence that devices protect against injury. Future guidelines should address these outcomes separately.