Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.

TitleReceipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.
Publication TypeJournal Article
Year of Publication2017
AuthorsHoffman, GJ, Hays, RD, Wallace, SP, Shapiro, MF, Yakusheva, O, Ettner, SL
JournalMed Care
Date Published2017 04
ISSN Number1537-1948
KeywordsAccidental Falls, Activities of Daily Living, Aged, Aged, 80 and over, Caregivers, Female, Geriatric Assessment, Humans, Independent Living, Longitudinal Studies, Male, Middle Aged, Risk Assessment, Risk Factors, United States

BACKGROUND: Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk.

DESIGN: Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (≥14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (≥3 activities of daily living) or cognitive limitations moderated this relationship.

RESULTS: Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (P<0.001) had stronger associations with reduced fall risk relative to low levels of informal care. Among individuals with ≥3 activities of daily living, fall risks were reduced by 21% for those receiving high levels of informal care; additionally, FRIs were reduced by 42% and 58% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54% FRI risk reduction among the cognitively impaired.

CONCLUSIONS: Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

User Guide Notes

Short TitleMedical Care
Alternate JournalMed Care
Citation Key8816
PubMed ID27875481
PubMed Central IDPMC5352465
Grant ListTL1 TR000121 / TR / NCATS NIH HHS / United States
U2C CA186878 / CA / NCI NIH HHS / United States
P20 MD000182 / MD / NIMHD NIH HHS / United States
P30 AG021684 / AG / NIA NIH HHS / United States
T32 HS000046 / HS / AHRQ HHS / United States