Risk factors for falls in older people in Germany: Results from the study Gesundheit 65+

Abstract Background Falls in older people can lead to serious injury, hospitalisation, loss of autonomy, and premature death. Falls often result from interacting, reducible or manageable risks. Known risk factors for falls include age, previous falls, multimorbidity, polypharmacy, mobility or visual impairment. The population-based study on health of older people in Germany (Gesundheit 65+) examines the 12-month prevalence of falls and the influence of known risk factors for falls. Methods Gesundheit 65+ is part of the nationwide health monitoring of the Robert Koch Institute (study period June 2021 to April 2023). Study participants were interviewed a total of four times, at baseline and 3 follow-ups within 12 months after baseline. The occurrence of a fall was recorded at each time point. A total of 2,925 participants (47% women; 44% 65-79 years, maximum age 101 years) provided complete information on baseline fall risk factors, falls in the past 12 months before baseline (FBB), and falls within 12 months after baseline (FAB). Weighted prevalences and a logistic regression were calculated. Results The 12-month prevalence of FBB was 26.9%. 53.6% of participants with FBB (confidence interval CI 48.3-58.8) had FAB, compared to 18.1% (CI 16.1-20.2) without FBB. We found no sex but age-group differences; participants 80+ had more FBB/FAB than those aged 65-79. Logistic regression showed that FBB (odds ratio OR 3.3), using walking aids (OR 2.2), activity limitations due to illness (OR 1.5), multimorbidity (OR 1.5) and age in years (OR 1.03) at baseline were significant risk factors for FAB; in women, reduced physical activity (OR 1.7), and in participants aged 65-79, severe visual impairment (OR 3.3) were additional risk factors. Conclusions Falls are a frequent incident in older adults with multimorbidity or limitations like use of walking aids. To prevent falls, preventive approaches should aim to raise awareness of the risks among both health professionals and older people. Key messages • Age-related falls are common but not inevitable. • Special attention should be paid to people who have already fallen or to people with reduced mobility.