Does Chronic Kidney Disease Drive Fall Risk in Community-Dwelling Older Adults? Data from baseline phase of Birjand Longitudinal Aging Study

Background: Falls represent a significant public health concern, particularly among the elderly. Chronic kidney disease (CKD) is a multifaceted condition associated with frailty, sarcopenia, and polypharmacy, all of which increase the risk of falls. This study aimed to evaluate the association between CKD severity and the risk of falls among elderly individuals in Birjand, Iran. Methods: This prospective cohort study included 1,344 elderly participants from the Birjand Longitudinal Aging Study. CKD severity was classified based on estimated glomerular filtration rate (eGFR), and falls were self-reported at specified intervals. Logistic and Cox regression models were used to examine the association between CKD severity and fall risk. Results: Fallers (n=82) were older, predominantly female, and had a higher prevalence of comorbidities compared to non-fallers (n=1,262). Mild CKD was significantly associated with increased odds (OR:1.98, 95% CI: 1.23–3.18, p=0.005) and hazard (HR: 2.22, 95% CI: 1.38–3.58, p=0.001) of falls in crude models. However, after adjusting for confounders, these associations became weaker and even non-significant (OR: 1.39, 95% CI: 0.83 – 2.31, p=0.209 and HR: 1.67, 95% CI: 1.01 – 2.77, p=0.047). Severe CKD was not consistently associated with fall risk in any models. Conclusion: Mild CKD is associated with an increased risk of falls in older adults; however, this relationship is influenced by confounders such as sex, comorbidities, and anthropometric factors. The findings underscore the importance of addressing fall risk through multifaceted interventions targeting comorbidity management in elderly CKD patients.