Rehabilitation Utilization for Falls Among Community-Dwelling Older Adults in the United States in the National Health and Aging Trends Study.

ABSTRACT

OBJECTIVE: To determine the characteristics of community-dwelling older adults receiving fall-related rehabilitation. DESIGN: Cross-sectional analysis of the fifth round (2015) of the National Health and Aging Trends Study (NHATS). Fall-related rehabilitation utilization was analyzed using weighted multinomial logistic regression with SEs adjusted for the sample design. SETTING: In-person interviews of a nationally representative sample of community-dwelling older adults. PARTICIPANTS: Medicare beneficiaries from NHATS (N=7062). INTERVENTIONS: Not applicable. MAIN OUTCOMES MEASURES: Rehabilitation utilization categorized into fall-related rehabilitation, other rehabilitation, or no rehabilitation. RESULTS: Fall status (single fall odds ratio [OR]=2.96; 95% confidence interval [CI], 1.52-5.77; recurrent falls OR=14.21; 95% CI, 7.45-27.10), fear of falling (OR=3.11; 95% CI, 1.90-5.08), poor Short Physical Performance Battery scores (score 0 OR=6.62; 95% CI, 3.31-13.24; score 1-4 OR=4.65; 95% CI, 2.23-9.68), and hip fracture (OR=3.24; 95% CI, 1.46-7.20) were all associated with receiving fall-related rehabilitation. Lower education level (less than high school diploma compared with 4-y college degree OR=.21; 95% CI, .11-.40) and Hispanic ethnicity (OR=.37; 95% CI, .15-.87) were associated with not receiving fall-related rehabilitation. CONCLUSIONS: Hispanic older adults and older adults who are less educated are less likely to receive fall-related rehabilitation. Recurrent fallers followed by those who fell once in the past year were more likely to receive fall-related rehabilitation than are older adults who have not had a fall in the past year.