Older Adult Falls as a Predictor of Nursing Facility Placement

Abstract

Background: Unintentional falls are a leading cause of injury, disability, and healthcare utilization among older adults (65+). Methods: Using the 2016–2021 Medicare Current Beneficiary Survey data, we examined the relationship between falls and nursing facility placement. Data from a cohort of 31 517 community-dwelling older adults were analyzed to assess fall prevalence at baseline and its association with nursing home placement in the following year. Multivariate regression models adjusted for demographic, health status, and functional limitations. Results: Falls were reported by 22.6% of participants at baseline and were higher among older females, white people, and those with poor health status, multiple chronic conditions, and existing functional limitations. Falls significantly increased risk of nursing home placement in the following year with an adjusted risk ratio (aRR) = 1.24 for any nursing facility, aRR = 1.51 for nursing home, and aRR = 1.18 for skilled nursing facilities. Conclusion: These findings underscore the strong association between falls and nursing facility placement, particularly among older adults with poorer health and multimorbidity. Preventative strategies targeting modifiable fall risk factors, such as strength and balance training, chronic disease management, and home safety intervention, could reduce fall incidence and the need for placement in nursing facilities.