Risk factors of falls in elderly patients attending the emergency department: A nested case‐control study in a local emergency department in Hong Kong

Abstract Background Fall in elderly patients is a significant public health issue in Hong Kong and worldwide. Given the aging population and unique background of Hong Kong, it is necessary to conduct a local study about the risk factors of falls in elderly patients and formulate specific strategies to help reduce their risk of falls. Objective To determine the factors associated with isolated and recurrent falls in elderly patients. Methods A nested case‐control study was carried out. The subjects were elderly patients who attended a local emergency department in Hong Kong from April 2023 to July 2024 for geriatric syndromes, low acuity medical problems, or social care problems, and were recruited into a program for focused geriatric assessment and support. Case was defined as patients attending for fall and having ≥1 fall events in past 1 year; whereas control was defined as patients attending for any conditions other than fall and having no fall events in past 1 year. Matching was conducted on a 1:1 ratio based on gender, age, date and time of attendance. Results There were 352 subjects, with a mean age of 80.2 years (SD 8.2 years), and 61.6% of them were females. The average number of fall events was 1 per year (SD 1.4 per year). Barthel index was the only significant predictor for isolated falls (OR = 0.873, 95% CI 0.199–0.953; p = 0.002), while the significant predictors for recurrent falls included poor vision (OR 2.351; 95% CI 1.131–4.888; p = 0.022), feeling “slow down” in the past 6 months (OR 2.811; 95% CI 1.299–6.084; p = 0.009) and loss of weight in the past 3 months (OR 3.701; 95% CI 1.327–10.322; p = 0.012). Conclusion This study highlighted the importance of functional impairment, poor vision, poor self‐confidence, and recent weight loss as key predictors for isolated and recurrent falls in elderly patients.