Mobility as a Predictor of New Falls in Older Adults Following Hip Fracture.

To investigate the association between mobility and the occurrence of new fall events following a hip fracture.

This was a 12-month prospective longitudinal study conducted with older adults admitted to a public hospital in Ribeirão Preto/SP, Brazil, after sustaining a fragility hip fracture. Within 24 hours of surgery, participants were assessed regarding their pre-fracture functional ability using the New Mobility Score (NMS). The Cumulated Ambulation Score (CAS) was administered to evaluate participants’ basic mobility up to 15 days post-surgery. The study was approved by the Research Ethics Committee (CAAE: 76918324.3.0000.5440). Binary logistic regression, adjusted for age, was performed to assess whether mobility (pre- or post-fracture) was associated with the occurrence of prospective falls (yes or no - dependent variable) within a 12-month period. The analysis was conducted using JASP software, version 0.18.3.0, with a significance level set at 5% (p ≤ 0.05). 

A total of 151 participants were evaluated, including 102 females (67.6%) and 49 males (32.4%), with a mean age of 79.5 years (SD = 8.67). Adjusted binary logistic regression revealed an association between prospective falls and CAS [X²(2) = 6.440, p 0.005; Nagelkerke R² = 0.169], correctly predicting 72% of cases (with 88.2% accuracy for those who did not fall). An increase of 1 point in CAS was associated with a 1.6-fold increase in the likelihood of not falling within 12 months (OR = 1.624, 95% CI: 1.015 – 2.600), indicating that basic mobility following hip fracture serves as a protective factor against falls. In contrast, pre-fracture NMS was not associated with fall occurrence [X²(2) = 1.384, p = 0.57; Nagelkerke R² = 0.036]. 

Basic mobility after a hip fracture appears to be a predictor of prospective falls, whereas pre-fracture functional ability does not seem to be associated with falls within 12 months.

By identifying basic mobility as a predictive factor, older adults who exhibit a low level of basic mobility within 15 days after surgery should be referred to a physiotherapy program focused on personalized interventions to improve functional mobility to prevent recurrent falls.