Abstract
BACKGROUND: Osteoarthritis (OA), the most prevalent joint disease, is associated with impaired mobility and may contribute to fall risk in older adults. Recurrent falls (≥two falls/year) are of particular concern due to their impact on morbidity and independence. This study is the first to examine whether individuals with early hip and/or knee OA are at increased risk of recurrent falls within 12 months of diagnosis and to identify biopsychosocial factors associated with fall risk. METHODS: Data were derived from the Osteoarthritis Initiative (OAI), a retrospective cohort of 4,427 participants stratified into four groups: individuals without OA, with knee OA, with hip OA, and with combined hip and knee OA. Self-reported recurrent falls within 12 months post-diagnosis were analyzed. Correlation and multivariable logistic regression analyses were conducted to identify predictive factors and interactions. RESULTS: The presence of OA alone was not independently associated with recurrent falls in short term. However, multivariable logistic regression identified several factors associated with recurrent falls. There was a trend toward increased odds among participants with hip OA (OR = 2.35, p = 0.062). Individuals under 65 years had lower odds of recurrent falls compared to older adults (OR = 0.752, p = 0.034), and better physical function was protective (SF-12: OR = 0.980, p = 0.005). Depressive symptoms were associated with increased odds (CES-D: OR = 1.024 per point, p = 0.005). Interaction analysis showed that depression particularly increased recurrent falls risk in those with knee OA (OR = 1.036, p = 0.034), while younger age was protective among individuals with hip OA (OR = 0.230, p = 0.036). CONCLUSIONS: While Osteoarthritis itself does not directly predict recurrent falls in short term, its risk in individuals with OA is shaped by a multifactorial interplay of age, marital status, ethnicity, physical functioning, and depressive symptoms, with specific interactions involving OA location. Therefore, a differentiated assessment and multidisciplinary approach addressing these factors are essential to reduce recurrent falls in this population.