Discrepancies between Perceived and Physiological Fall Risks and Repeated Falls among Community-Dwelling Medicare Beneficiaries Aged 65 Years and Older.

ABSTRACT

OBJECTIVES: This study examined the associations of discrepancies between perceived and physiological fall risks with repeated falls. METHODS: We analyzed the 2016 Medicare Current Beneficiary Survey of 2,487 Medicare beneficiaries aged ≥ 65 years with ≥ 1 fall. The outcome variable was repeated falls (≥ 2 falls), the key independent variable was a categorical variable of discrepancies between perceived (fear of falling) and physiological fall risks (physiological limitations), assessed using multivariate logistic regression. RESULTS: Among Medicare beneficiaries with ≥ 1 fall, 25.1% had low fear of falling but high physiological fall risk (Low Fear-High Physiological), 9.4% had high fear of falling but low physiological fall risk (High Fear-Low Physiological), 23.5% had low fear of falling and low physiological fall risks (Low Fear-Low Physiological), and 42.0% had high fear of falling and high physiological fall risks (High Fear-High Physiological). Having High Fear-High Physiological was associated with repeated falls (OR = 2.14; p < .001) compared to Low Fear-Low Physiological. Having Low Fear-High Physiological and High Fear-LowPhysiological were not associated with repeated falls. CONCLUSIONS: Given that High Fear-High Physiological was associated with repeated falls and that many at-risk Medicare beneficiaries had High Fear-High Physiological, prevention efforts may consider targeting those most at-risk including Medicare beneficiaries with High Fear-High Physiological. CLINICAL IMPLICATIONS Assessing both perceived and physiological fall risks is clinically relevant, given it may inform targeted interventions for different at-risk Medicare beneficiaries among clinicians and other stakeholders.