“Falls in older people receiving home healthcare services at armed forces hospital Southern Region: prevalence, associated factors, and consequent injuries”

Falls are a major cause of morbidity and loss of independence among older adults, particularly those receiving home healthcare services due to advanced age, multimorbidity, and environmental hazards. Despite the expansion of Home Health Care (HHC) services in Saudi Arabia, evidence regarding fall prevalence, associated factors, and home-related hazards among HHC recipients remains limited. To determine the prevalence of falls and related injuries and to examine medical, medication-related, and environmental factors associated with falls among older adults receiving HHC services at the Armed Forces Hospital, Southern Region. A cross-sectional study was conducted over three months among adults aged ≥ 65 years enrolled in the HHC program. A total of 368 participants were selected using systematic random sampling. Data were collected through structured interviews, medical record review, the Missouri Alliance for Home Care 10-Fall Risk Assessment Tool, and a home safety evaluation using the CDC STEADI tool. Descriptive and inferential statistics (Chi-square test, Fisher’s exact test, and independent t-test) were applied, with statistical significance set at p < 0.05. The 12-month prevalence of falls was 20.9%; most participants who reported falls experienced a single event (76.6%), and fractures were reported in 2.4%. Stroke (p = 0.009) and depression (p = 0.024) were significantly associated with fall occurrence. Antipsychotics (p = 0.009) and antidepressants (p < 0.001) were significantly associated with falls. Higher fall-risk assessment scores were also significantly associated with fall occurrence (p = 0.001). Environmental hazards, particularly broken or uneven steps and absence of handrails, demonstrated significant associations with falls. Falls among older adults receiving HHC services were significantly associated with specific comorbidities, psychotropic medication use, higher fall-risk scores, and hazardous home environmental conditions. These findings highlight the importance of targeted fall-prevention interventions focusing on potentially modifiable associated factors to enhance safety in this population.