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

Author

Listed:
  • 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
    Severance Underwood Meta-Research Center, Yonsei University)

  • 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
    Assistance Publique - Hôpitaux de Paris (AP-HP) / Université Paris Cité, Lariboisière - Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation
    Inserm / Université Paris Cité, UMR 1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing))

  • Ai Koyanagi

    (Research and Development Unit)

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.

Suggested Citation

  • 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 & Ai Koyanagi, 2025. "The association between physical multimorbidity and fall-related injury among adults aged ≥ 50 years from low- and middle-income countries," European Journal of Ageing, Springer, vol. 22(1), pages 1-10, December.
    • Handle: RePEc:spr:eujoag:v:22:y:2025:i:1:d:10.1007_s10433-025-00848-y
    DOI: 10.1007/s10433-025-00848-y
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