The Relationship Between Functional Limitation and Fall Injury Among Older Adults: A 12-Year National Survey Analysis

Background: One in four US adults aged ≥65 years experiences a fall annually, leading to substantial injury and morbidity. Functional limitations may serve as early markers of vulnerability to fall injury. We aimed to estimate temporal trends and the association between functional limitation and fall injuries among community-dwelling older adults. Methods: For this retrospective cohort analysis, we pooled 2006–2017 National Health Interview Survey data and identified older adult survey respondents. Functional limitation, defined as any reported difficulty performing daily activities, and fall injury, defined as occurring within three months prior to the interview, were measured as binary variables. We controlled for sociodemographic, self-rated health, healthcare access, and physical activity factors. We reported the yearly trend in fall injury and functional limitations and performed survey-weighted univariable and multivariable logistic regression analyses, accounting for the potential confounders. Results: Our sample comprised 79,891 older adults, of whom 66% reported functional limitations and 2.3% reported a fall injury within 3 months of their interview. The prevalence of functional limitation increased from 61.8% in 2007 to 68.4% in 2017 (p<0.001). Also, the fall injury rates ranged from 1.8% to 2.6% during the same period. Older adults with functional limitations were more likely to report fall injuries (3.2% vs. 1.1%, p<0.001). After adjustment, functional limitation was associated with a two-fold higher odds of fall injury (OR = 2.03, 95% CI 1.71–2.40). Conclusion: Functional limitations are highly prevalent and increasing among older U.S. adults, doubling the likelihood of fall injury occurrence.