Hypertension and Fall Risk in Chinese Community-Dwelling Older Adults: The Mediating Role of Frailty

BACKGROUND: There is an association of hypertension and frailty with an increased risk of falls. Importantly, frailty may serve as a mediating factor in the relationship between hypertension and fall risk. It is known that frailty is a dynamic, reversible process rather than a fixed, unchangeable state. This implies that through early intervention and effective management strategies, frailty can be modulated in older adults with hypertension, thereby reducing their risk of falling. Currently, there is a lack of published studies examining the mediating effects of frailty on the relationship between hypertension and falls. OBJECTIVES: In this study, we aimed to examine the mediating role of frailty in the relationship between hypertension and fall risk among community-dwelling older adults. METHODS: This cross-sectional study involved 357 older adults from China. Data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, Spearman correlation analysis, and mediation analysis with the PROCESS macro. RESULTS: Univariate analysis indicated that age, occupation, marital status, per capita monthly income, polypharmacy, the number of chronic diseases, and hypertension were significantly associated with risk of falls. Correlation analysis revealed a significant link between hypertension, fall risk, and frailty. After controlling for covariates, frailty was found to partially mediate the relationship between hypertension and fall risk, accounting for 21.60% of the relationship. CONCLUSION: Frailty played a mediating role in the connection between hypertension and fall risk. Since frailty is a modifiable factor, interventions aimed at reducing frailty should be developed and tested to determine if they could positively influence fall risk among older individuals with hypertension in the community.