Older American Indian and Alaska Native adults with a fear of falling: Prevalence and correlates of falling and falls needing medical treatment

Background Older American Indian and Alaska Native (AIAN) peoples are at greatest risk for falls and fall-related injuries than any race or ethnic group. Compared to same-aged peers of other races, older AIAN peoples have the highest rate of falls. Yet, little research has been pursued that would improve our understanding of falls within this high-risk population. Thus, we descriptively examined falls and falls that needed medical attention as well as their correlates among those with a fear of falling in this at-risk population. Methods We used National Resource Center on Native American Aging survey data collected between 2020 and 2023 from community-dwelling older AIAN peoples. Our analytic sample consisted of data from 6,809 respondents aged ≥ 55 years who had a fear of falling. Logistic regressions were estimated to identify significant correlates of falls and falls that needed medical attention for the entire sample and stratified by gender. Results Findings indicated that 79.3% of the sample had ≥ 1 fall(s) in the past year with a mean of 2.8 ± 5.0 falls. Of those who fell in the past year, 37.2% had ≥ 1 fall(s) needing medical treatment. Correlates for having ≥ 1 fall(s) included male gender, lower annual personal income, depression, and more activities of daily living (ADL) limitations. Correlates of ≥ 1 fall(s) that needed medical treatment included female gender, osteoporosis, poorer self-rated health, and more ADL limitations. For women, correlates of ≥ 1 fall(s) were diabetes, depression, and more ADL limitations, and for men, correlates were lower annual personal income and more ADL limitations. Correlates of falls that needed medical treatment among women were increased body mass index, poorer self-rated health, and more ADL limitations. Correlates of falls that needed medical treatment among men were lower annual personal income, osteoporosis, and more ADL limitations. Conclusion Given AIAN peoples’ increased risk for falls and fall-related injury, it is important that there are efforts to improve our understanding of falls in this population. The need of supporting existing and increasing falls prevention efforts for AIAN peoples will become more critical with the expected growth of this population. Clinical trial number: Not applicable