Association between Cardiovascular-Kidney-Metabolic (CKM) syndrome staging and falls among community-dwelling older adults: a cross-sectional study

To investigate the association between the severity of Cardiovascular-Kidney-Metabolic (CKM) syndrome and the prevalence of falls in community-dwelling older adults. This cross-sectional study included 41,852 community-dwelling older adults from the China Ageing and Health Survey (CAHS). The CKM syndrome was staged from 0 to 4 based on the 2023 American Heart Association scientific statement. The outcome was the prevalence of falls. We used multivariable logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for falls across CKM stages. The prevalence of falls was 9.1% (3,806/41,852). After adjusting for a comprehensive set of confounders including demographics, lifestyle factors, physical function, and cognitive function, participants in higher CKM stages had significantly higher odds of having experienced falls compared to those in Stage 0. The adjusted ORs were 0.855 (95% CI, 0.746–0.979) for Stage 1, 1.084 (95% CI, 0.961–1.222) for Stage 2, 1.304 (95% CI, 1.137–1.495) for Stage 3, and 1.625 (95% CI, 1.434–1.842) for Stage 4. A significant dose-response relationship was observed (P-trend < 0.001). The association was more pronounced in individuals aged < 75 years (P-interaction < 0.001) and those living in rural/town areas (P-interaction = 0.020). The severity of CKM syndrome is independently and incrementally associated with a higher prevalence of falls among community-dwelling older adults. CKM staging may serve as an integrated marker to identify individuals with a higher burden of falls, highlighting the importance of managing CKM health.