Prevalence and risk factors of falls among older adults in the United States: a cross-sectional study

Abstract

Several studies have examined falls among older adults in the United States; however, studies using recent nationally representative data to evaluate fall prevalence and associated factors in this population are limited. We investigated the current prevalence of falls among older adults in the United States and examined the demographic and health-related factors associated with falls. Using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS) dataset, we investigated the weighted prevalence of falls among older adults aged ≥ 60 years and conducted bivariate and multivariate analyses to determine the factors associated with falls using “at least one fall in the last 12 months” as the dependent variable. Analyses incorporated the BRFSS final sampling weight (_LLCPWT), stratification variable (_STSTR), and primary sampling unit (_PSU) using the Complex Samples module in IBM SPSS Statistics. Among adults aged ≥ 60 years in the 2023 BRFSS, the weighted prevalence of at least one fall in the previous 12 months was 27.0% (95% CI: 26.5–27.4). Participants aged ≥ 80 years had higher odds of falling than those aged 60–69 years (aOR = 1.13, 95% CI: 1.07–1.18). Female sex (aOR = 1.09, 95% CI: 1.05–1.13), annual household income <$25,000 (aOR = 1.06, 95% CI: 1.01–1.11), and not working (aOR = 1.21, 95% CI: 1.15–1.26) were independent factors associated with falls. Contrarily, participants with less than a high school education had lower odds of reporting a fall compared with those with a high school education or higher (aOR = 0.75, 95% CI: 0.69–0.81). Poor general health (aOR = 1.46, 95% CI: 1.40–1.53), visual difficulty (aOR = 1.27, 95% CI: 1.19–1.36), hearing loss (aOR = 1.26, 95% CI: 1.19–1.32), arthritis (aOR = 1.43, 95% CI: 1.38–1.49, P < 0.001), difficulty concentrating/deciding (aOR = 2.09, 95% CI: 1.98–2.21, P < 0.001), and difficulty climbing stairs/moving (aOR = 2.36, 95% CI: 2.26–2.47, P < 0.001) were strongly associated with falls. Falls were associated with several demographic, socioeconomic, health-related, sensory, cognitive, and functional factors. These findings highlight the need for comprehensive fall-prevention strategies that address modifiable risk factors to reduce the burden of falls in aging populations.