Falls and related injury among middle-aged people aging with long-term disability are common and associated with disability symptoms

BACKGROUND: Falls and related injury are understudied among people aging with long-term physical disabilities (PAwLTPD). OBJECTIVES: This study examined the prevalence of falling and injury among PAwLTPD over three years and explored associations of disability-related symptoms with these outcomes. METHODS: A longitudinal survey (annual, three years: T0, T1, T2) was conducted among PAwLTPD (45-65 years). Participants were queried about whether they fell in the past year and fall-related injury. PROMIS measures were used to assess depression, fatigue, and pain. RESULTS: 323 PAwLTPD (69% women, 63% White, average age 56 years, average 19 years with disability) completed the three annual surveys. Over 65% fell in the past year at T0. Participants had lower odds of falling at T1 (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.36-0.85) and at T2 (OR 0.55, CI 0.36-0.85). Approximately 40% fell in all three years. At T0, 15% fell with major injury. The odds of falling with major injury were lower at T1 (OR 0.15, CI 0.06-0.37) and T2 (OR 0.17, CI 0.07-0.40). In multivariable models, increasing fatigue T-score was associated with increased odds of falling (adjusted OR [aOR] 1.08, CI 1.05-1.12), falling all three years (aOR 1.12, CI 1.06-1.18), and minor injury (aOR 1.09, CI 1.05-1.13). CONCLUSION: Falls across multiple years and related injury are common among PAwLTPD and associated with disability symptoms. Regular screening and interventions to manage these conditions, including fatigue, should be researched as possible methods to decrease falls and injury among this understudied population.