Prevalence and Associated Factors of Falls Among Iranian Older Adults: Findings from the Neyshabur Longitudinal Study on Ageing (NeLSA)

ABSTRACT
Background: Falls are a major cause of disability, loss of independence, hospitalization, and mortality among older adults. Despite the growing burden of falls in Iran, population-based evidence on their prevalence and associated factors remains limited. To determine the prevalence of falls and identify factors associated with fall occurrence in the Neyshabur Longitudinal Study on Ageing (NeLSA).
Methods: This cross-sectional study used baseline data from the NeLSA cohort. A total of 3,452 adults aged ≥60 years were included, of whom 3,319 had available information on falls during the previous 12 months. Standardized questionnaires and clinical assessments were used to assess demographic, socioeconomic, clinical, and psychological measures. Multivariable logistic regression analyses were performed to identify factors independently associated with falls.
Results: Among 3,319 participants, 744 reported at least one fall during the previous 12 months, corresponding to a prevalence of 22.4%. In the model excluding fear of falling, older age (AOR=1.022, 95% CI: 1.008–1.037), urinary incontinence (AOR=1.589, 95% CI: 1.086–2.326), poorer sleep quality (AOR=1.047, 95% CI: 1.023–1.072), depressive symptoms (AOR=1.081, 95% CI: 1.039–1.125), and lower income status were independently associated with falls. After adjustment for fear of falling, model fit improved, and fear of falling showed the strongest independent association with fall occurrence. Participants with some fear (AOR=1.646, 95% CI: 1.338–2.025) and high fear (AOR=2.414, 95% CI: 1.847–3.155) were significantly more likely to fall. Older age, urinary incontinence, poor sleep quality, depressive symptoms, and lower income status remained significant factors in the fully adjusted model.
Conclusions: Falls affected more than one-fifth of participants in the NeLSA and were associated with a combination of clinical, psychological, and socioeconomic factors. Fear of falling showed the strongest independent association with fall occurrence, supporting the integration of psychological assessment into routine fall-risk screening and prevention programs.