Association between frailty status and falling in older adults with hip fracture: a cross-sectional study

ABSTRACT

Objectives

There is limited research on the relationship between frailty status and falls in hip fractures in older participants. This study aimed to investigate the relationship between frailty and falls in older adults who had experienced a hip fracture.

Methods

From June 2023 to January 2024, the study population comprised 253 hip fracture patients aged 60 years and over. They were admitted to the orthopedic department of a tertiary care hospital. We excluded participants with incomplete information. The 5-item FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight) was used to assess frailty status and the patient’s self-reported falls. We analyzed the relationship between frailty and falls in older hip fracture patients using logistic regression models, subgroup analyses, and stratified analyses.

Results

Finally, 174 older participants with hip fractures were identified in this study, where 155 (89.1%) had falls. Among 155 falls, 39 (78.0%) were in the robust group, 65 (91.5%) were in the pre-frail group, and 51 (96.2%) were in the frail group. An analysis revealed that among more than 60 years old hip fracture patients, each additional point in frailty score was significantly linked to a higher likelihood of experiencing a fall (OR: 1.97, 95%CI: 1.10–3.52, p < 0.05). While frailty appeared as a categorical variable, this association was stronger with an OR of 2.68 (95% CI: 0.71–10.21) in the pre-frailty group and 7.95 (95% CI: 1.11–57.08), compared to the robust group (p for trend < 0.005). In subgroup analyses, an interaction was observed between frailty and falling according to sex. In stratified analyses, the relationship between frailty status and fall significantly differed between the male and female groups (male OR: 1.49, 95% CI: 0.71 t–3.13; female OR: 7.54, 95% CI: 1.13 to 50.32, p for interaction = 0.043).

Conclusions

The study revealed a notable correlation between frailty and falls, with gender and frailty showing an interaction impact on the increased occurrence of falls. Therefore, further research across diverse disease populations is needed to explore the link between frailty status and falls. Large-scale prospective studies are necessary to clarify the causality of this relationship.

Clinical trial registration

Chinese Clinical Trial Registry (ChiCTR2300073031).

KEYWORDS:

• Hip fracture
• Frailty
• Cross-sectional study
• Fall

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Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

None stated.

Author contributions

Study concept and design: Lan Jiang, Xuwei Yao; acquisition of data: Lili Yang, Ziyuan Hong; analysis and interpretation of data: Ziyuan Hong, Lan Jiang; drafting of the manuscript: Lan Jiang; critical revision of the manuscript for important intellectual content: Xuewei Yao.

Table 4 Stratified analyses association between frailty and fall of gender.

Additional information

Funding

This paper was not funded.