The Incidence and Predictors of Falling in Older Adults: The Results of Follow-Up in Iranian Multicenter Osteoporosis Study (Imos) Publisher Pubmed



Ahmadi M ; Sargolzaeimoghaddam M ; Mohseni V ; Khalagi K ; Mansourzadeh M J ; Akbarpour S ; Shafiee G ; Sanjari M ; Fahimfar N ; Ostovar A
Source: Osteoporosis International Published:2026

Abstract

Summary: In this prospective cohort of 1,410 community-dwelling Iranian older adults, a history of falls in the previous year was the strongest independent predictor of incident falls over one-year follow-up, supporting routine fall-history assessment as part of fracture-risk stratification. Background: Osteoporosis and falls are closely interlinked, particularly among aging populations, leading to increased risks of fragility fractures and disability. Identifying fall-related risk factors is essential for guiding prevention strategies. Objective: This study aimed to investigate the incidence of falls and associated risk factors among community-dwelling older adults in Iran over a one-year follow-up period. Methods: Individuals aged ≥ 50 years, who participated in the Iranian Multicenter Osteoporosis Study were followed. Baseline data included demographics, medical history, functional assessments, and laboratory findings. Falls were tracked prospectively over 12 months through phone calls. Statistical analyses included chi-square tests for categorical variables, independent t-tests for numerical comparisons, and Cox proportional hazards regression to identify predictors of falls. Variables with p < 0.20 in univariable analyses were entered into the multivariable model. Results: Among 1,450 participants at baseline, 1,410 (54.6% women; mean age 60.7 ± 8.0 years) completed follow-up. The overall fall incidence rate was 14.27 per 1,000 person-years (95% CI: 12.64–16.09), with higher rates among women than men. In unadjusted analyses, female sex, higher BMI, dizziness, visual impairment, and prior fall history were associated with increased fall risk. After multivariable adjustment, a history of one fall during past year (HR:2.49, 95%CI:1.76-3.70), two or more falls during past year (HR:2.55, 95%CI:1.74-3.70) and visual impairment (HR:1.48,95%CI:1.05-2.08) remained independent predictors of incident falls. Those with a fall in the previous year showed more than a 2.7-fold higher risk of subsequent falls (HR = 2.70; 95% CI: 1.99–3.66; p < 0.001). Conclusion: History of previous falls was the important independent predictor of incident falls after adjustment, highlighting the importance of systematic fall-history assessment in community-dwelling older adults. © The Author(s), under exclusive licence to the International Osteoporosis Foundation and the Bone Health and Osteoporosis Foundation 2026.