Recurrent fall as a predictor of short-term functional outcomes after hip fracture in older adults

Purpose. Hip fracture (HP) incidence has increased worldwide, with 90% resulting from falls, a preventable event. Identifying fall history prior to a HP is essential to better understand older adults’ conditions and recovery potential. Methods. This prospective cohort study aimed to examine whether recurrent fallers (RF) differ from single fallers (SF) in intrinsic health characteristics and to assess the association between fall history and functional performance 3-months post-fracture. A total of 134 older adults hospitalized for HF were included and categorized into SF (n=84) and RF (n=50) based on fall history in the previous year. Clinical and surgical data, fall history, self-perceived health and balance, handgrip strength (HGS), New Mobility Score (NMS), and post-fracture mobility (Cumulated Ambulation Score) were assessed during hospitalization. After 3-months, reassessments included gait speed, Timed Up and Go, Short Physical Performance Battery (SPPB), isometric knee extension strength, and perceived effort. Statistical analyses included t-tests and chi-square for comparing groups and generalized linear models for assess association between the variables (SPSS 25.0; p≤0.05). Results. During hospitalization, RF showed lower HGS (p=0.01), outdoor mobility (p=0.02) and total NMS (p=0.03), worse emotional state (p=0.006) and balance perception (p=0.01). At 3-months, RF was associated with reduced outdoor mobility (p<0.001), higher perceived effort (p=0.02), slower gait speed (p=0.03) and lower knee extension strength (p=0.007) and SPPB scores for gait (p=0.001), balance (p=0.003), and total (p=0.002). Conclusion. These findings suggest that recurrent falls are linked to worse functional outcomes following HF in older adults, emphasizing the importance of fall risk stratification and early preventive interventions.