Association between frailty and fall risk in elderly patients with knee osteoarthritis in community: a propensity score matching analysis

To analyze the prevalence of frailty in community-dwelling older adults with knee osteoarthritis (KOA) and explore its independent association with fall risk. A cross-sectional study was conducted among older adults with KOA in Zunyi, China, from October 2022 to September 2023 using convenience sampling. Data were collected on sociodemographic characteristics, instrumental activities of daily living (IADL), depression, anxiety, sleep quality, frailty, and fall risk. Propensity score matching (PSM) was performed to match frail and non-frail participants at a 1:1 ratio using nearest-neighbor matching with a caliper of 0.05, based on sociodemographic and lifestyle variables. Conditional logistic regression analysis was then employed to adjust for other potential confounders and determine the strength of the association between frailty and fall risk. A total of 986 community-dwelling elderly patients with KOA were enrolled. The prevalence of frailty was 25.25%, and the proportion of individuals at high fall risk was 51.72%. After PSM, 470 matched participants were obtained (235 in each group). Conditional logistic regression analysis showed that frailty was significantly associated with high fall risk (P < 0.001), with frail individuals having a 5.21-fold higher likelihood of being at high fall risk than non-frail individuals (OR = 5.21, 95%CI 2.66-10.17). Additionally, poor self-rated health (OR = 7.38, 95%CI 1.20-45.46, P = 0.031) and IADL impairment (OR = 4.74, 95%CI 1.37-16.43, P = 0.014) were also significantly associated with increased fall risk. Frailty is independently associated with an increased fall risk in community-dwelling older adults with KOA. Routine frailty screening could be integrated into primary care for this population to support fall risk monitoring and stratified assessment.