The association between physical multimorbidity and fall-related injury among adults aged ≥ 50 years from low- and middle-income countries

Lee Smith, Guillermo F. López Sánchez (), Jae Il Shin (), Hans Oh, Karel Kostev, Mark A. Tully, Yvonne Barnett, Laurie T. Butler, Nicola Veronese, Pinar Soysal, Louis Jacob and Ai Koyanagi
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Lee Smith: Centre for Health Performance and Wellbeing, Anglia Ruskin University
Guillermo F. López Sánchez: University of Murcia
Jae Il Shin: Yonsei University College of Medicine
Hans Oh: University of Southern California
Karel Kostev: University Clinic of Marburg
Mark A. Tully: Ulster University
Yvonne Barnett: Centre for Health Performance and Wellbeing, Anglia Ruskin University
Laurie T. Butler: Centre for Health Performance and Wellbeing, Anglia Ruskin University
Nicola Veronese: Saint Camillus International University of Health Sciences, Faculty of Medicine
Pinar Soysal: Bezmialem Vakif University
Louis Jacob: Research and Development Unit
Ai Koyanagi: Research and Development Unit

European Journal of Ageing, 2025, vol. 22, issue 1, No 12, 10 pages

Abstract: Abstract Studies from high-income countries have shown that multimorbidity is associated with increased fall risk among older adults. However, studies specifically on this topic from low- and middle-income counties (LMICs) are lacking. Thus, we aimed to assess this association among adults aged ≥ 50 years from six LMICs. Cross-sectional, community-based data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. Eleven chronic physical conditions were assessed. The presence of past 12-month fall-related injury was ascertained through self-reported information. Multivariable logistic regression and mediation analysis was conducted to assess the association between multimorbidity and fall-related injury. Data on 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; males 48.0%] were analyzed. Overall, compared to having no chronic conditions, having 2, 3, and ≥ 4 chronic conditions were significantly associated with 1.67 (95%CI = 1.21–2.30), 2.64 (95%CI = 1.89–3.68), and 3.67 (95%CI = 2.42–5.57) times higher odds for fall-related injury. The association between multimorbidity (i.e., ≥ 2 chronic conditions) and fall-related injury was mainly explained by pain/discomfort (mediated% 39.7%), mobility (34.1%), sleep/energy (24.2%), and cognition (13.0%). Older adults with multimorbidity in LMICs are at increased odds for fall-related injury. Targeting the identified potential mediators among those with multimorbidity may reduce fall risk in this population.

Keywords: Low-and middle-income countries; Falls; Multimorbidity; Chronic disease; Epidemiology (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10433-025-00848-y

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