Abstract
BACKGROUND: This study aimed to identify fall risk indicators associated with future falls among older patients with cardiovascular disease (CVD), based on a multidimensional assessment. METHODS AND RESULTS: In this prospective cohort study, 129 patients aged ≥65 years with CVD were enrolled between 2021 and 2023. Participants were classified into fall and non-fall groups based on fall incidence during a 1-year follow up. We assessed physical frailty, systolic blood pressure, polypharmacy, and the Falls Efficacy Scale International (FES-I) to evaluate concern about falling. The overall 1-year fall incidence was 17.0% (22 falls), equating to 0.28 falls per person-year. Compared with the non-fall group, the fall group was older, had lower physical function and blood pressure, and higher FES-I scores. Multivariate logistic regression, adjusted with propensity scores, revealed that a FES-I score ≥28 was a significant predictor of falls (odds ratio [OR] 8.906, 95% confidence interval [CI] 2.556-13.031, P=0.001; adjusted OR 2.964, 95% CI 1.038-8.460, P=0.042). Receiver operating characteristic analysis identified a FES-I cut-off of 28, with an area under the curve of 0.684 (95% CI 0.527-0.840, P=0.017). CONCLUSIONS: The 1-year fall incidence among older patients with CVD was comparable with rates in community-dwelling older adults. Higher concern about falling, as measured using FES-I, was significantly associated with future falls.