Rehabilitation utilization for falls among community-dwelling older adults in the United States in the National Health and Aging Trends Study

Publication date: Available online 12 March 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Briana L. Moreland, Laura L. Durbin, Judith D. Kasper, Thelma J. Mielenz
ObjectivesTo determine the characteristics of community-dwelling older adults receiving fall-related rehabilitation. Injurious falls cost billions of dollars each year in the United States and these costs are expected to rise. Fall-related rehabilitation can presumably decrease this burden. More needs to be known about the characteristics of older adults utilizing fall-related rehabilitation services.DesignCross-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 standard errors adjusted for the sample design.SettingIn-person interviews of a nationally representative sample of community-dwelling older adults.Participants7,062 Medicare beneficiaries from NHATS.InterventionsNot ApplicableMain Outcomes MeasuresRehabilitation utilization categorized into fall-related rehabilitation, other rehabilitation, or no rehabilitation.ResultsFall status (single fall OR=2.96, CI: 1.52, 5.77; recurrent falls OR=14.21, CI: 7.45, 27.10), fear of falling (OR=3.11, CI: 1.90, 5.08), poor Short Physical Performance Battery scores (score 0 OR=6.62, CI: 3.31, 13.24; score 1-4 OR=4.65, CI:2.23, 9.68) and hip fracture (OR=3.24 CI: 1.46, 7.20) were all associated with receiving fall-related rehabilitation. Lower education level (less than high school diploma compared to 4-year college degree OR=0.21, CI: 0.11, 0.40) and Hispanic ethnicity (OR=0.37, CI: 0.15, 0.87) were associated with not receiving fall-related rehabilitation.ConclusionHispanic 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.



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