Association between basic movement ability and fall location in older acute-care inpatients: a retrospective observational study

Abstract Purpose We investigated whether basic movement ability was associated with whether a fall occurred inside or outside the patient room among older acute-care inpatients who had already experienced a fall. This study did not evaluate fall occurrence or fall risk in the overall inpatient population. Methods This retrospective study included 688 fall events among inpatients aged 65 years or older who were already receiving physical therapy when the fall occurred (May 2022 to February 2026). Falls were classified as occurring inside or outside the patient room. Three logistic regression models were built: Model 1 (age, days to fall, work shift), Model 2 (Model 1 plus ABMS II score), and Model 3 (Model 2 plus cognitive function). Fit was evaluated by the area under the receiver operating characteristic curve (AUC). Results Falls outside the room occurred in patients with higher ABMS II scores (median [IQR]: 27 [24–29] vs. 22 [18–26]). The AUC improved from 0.651 (Model 1) to 0.777 (Model 2) and 0.801 (Model 3). In Model 3, each additional ABMS II point was independently associated with higher odds of falls outside the room (OR: 1.20, 95% CI: 1.12–1.29, p < 0.001), while each one-category deterioration in pre-admission cognitive function was negatively associated (OR: 0.41, 95% CI: 0.25–0.67, p < 0.001). In an exploratory, hypothesis-generating analysis, an ABMS II cutoff of 26 points was associated with out-of-room falls after full adjustment (OR: 3.39, 95% CI: 2.01–5.72, p < 0.001). Conclusions Among older acute-care inpatients who experienced a fall, preserved basic movement ability was associated with the fall occurring outside the patient room. Basic movement ability may therefore provide useful information for characterizing the spatial context of falls among fallers.