Combined Impact of Knee Osteoarthritis and Diabetes Mellitus on Fall Incidence and Hospitalization Outcomes Among Malaysian Older Adults

Background Knee osteoarthritis (KOA) and diabetes mellitus (DM) are common in older adults and may increase fall and hospitalization risk.Objective To examine the combined effects of KOA and DM on falls and hospitalization among Malaysian older adults.Methods A 12-month prospective cohort study involved 207 adults aged ≥60 years from urban Malaysia, categorized as KOA − DM−, KOA − DM+, KOA+DM−, and KOA+DM+. Falls, fall-related injuries, and hospitalizations were assessed through structured telephone interviews.Results The mean age was 66.3 ± 5.7 years. During follow-up, 18.1% of participants without previous falls experienced a fall, with overall incidence of 11.1%. The highest fall rates were in KOA+DM− (15.0%) and KOA+DM+ (14.5%) groups. KOA significantly increased fall risk (adjusted OR = 3.41; 95% CI: 1.06–14.21), while DM did not. Hospitalizations occurred in 10.4%, most often among KOA − DM+ participants (30.0%).Conclusion KOA independently predicted falls, but no combined KOA-DM effect was found. Larger studies are warranted.