Falls After Stroke in a University Hospital Falls Clinic: A Retrospective Cross-Sectional Study

Background: Falls are a leading cause of morbidity among older adults and are particularly common after stroke. Although falls during the acute and subacute phases of stroke have been extensively studied, data on fall characteristics among community-dwelling older adults with chronic stroke , especially in Asian settings, remain limited. This study aimed to describe fall characteristics and outcomes among older adults with chronic stroke attending a dedicated Falls Clinic and to identify factors associated with falls in this population. Methods: We conducted a retrospective cross-sectional analysis of the University Malaya Medical Centre (UMMC) Falls Clinic registry from June 2013 to October 2018. Adults aged ≥ 60 years attending their first Falls Clinic visit were included. Participants with stroke onset > 6 months prior to presentation were classified as having chronic stroke. Sociodemographic characteristics, clinical factors, fall circumstances, and outcomes were compared between fallers with and without chronic stroke. Multivariable logistic regression was performed to identify factors independently associated with falls among chronic stroke survivors. Results: Among 778 eligible patients, 90 (11.6%) had chronic stroke (mean age 78.2 ± 7.2 years; 52.2% male). Compared with non-stroke fallers, chronic stroke fallers more frequently reported dizziness (37.8% vs 23.8%), falls aggravated by postural change (35.6% vs 20.3%), and indoor falls (55.6% vs 33.0%). Living with family was more common among chronic stroke fallers (33.3% vs 19.3%). Independent factors associated with falls among chronic stroke survivors included dizziness (OR 1.66, 95% CI 1.03–2.68), postural change (OR 1.96, 95% CI 1.20–3.18), indoor falls (OR 2.05, 95% CI 1.29–3.26), and living with family (OR 2.14, 95% CI 1.31–3.52). Emergency department attendance following a fall was more frequent in the chronic stroke group (10.0% vs 2.0%). Conclusion: Older adults with chronic stroke attending a Falls Clinic demonstrate distinct and largely modifiable fall profiles characterised by dizziness, postural change, indoor environmental factors, and family living arrangements. These findings support the integration of stroke-specific, multidimensional fall risk assessment into post-stroke and geriatric care pathways.