Latent profiles of falls self-awareness and associated factors in older maintenance hemodialysis patients

Falls are a significant concern for elderly Maintenance Hemodialysis (MHD) patients, with a rising fall-related mortality rate observed over the past decade. However, the heterogeneity of fall awareness within this population has not been sufficiently explored. Understanding these differences is crucial for developing targeted interventions to address fall risk. This cross-sectional study included 313 elderly MHD patients from a tertiary hospital in China (January-March 2025). Latent Profile Analysis (LPA) was utilized to identify distinct profiles of fall self-awareness based on the Self-Awareness of Falls in Elderly Scale (SAFE), which assesses four dimensions of fall awareness. Multivariate logistic regression analysis was performed to examine factors influencing these profiles, adjusting for demographic and clinical variables. Three latent profiles emerged: the Vulnerable Type (17.6%, low awareness across all dimensions, particularly in cognitive-behavioral aspects), the Balanced Type (48.9%, moderate awareness), and the Active Type (33.6%, high awareness in medication and environmental safety). Younger age, moderate or lower Charlson Comorbidity Index (CCI) scores, and a history of falls were significant predictors for membership in the Vulnerable/Balanced profiles. The findings highlight significant variability in fall awareness among elderly MHD patients, with over 65% demonstrating suboptimal awareness. These descriptive findings emphasize the meaningful variability in fall self-awareness among older MHD patients and may inform class-specific education and screening strategies. Prospective and interventional studies are needed to determine causal effects and evaluate their impact on fall events.