Hypertension and Fall Risk in Chinese Community-Dwelling Older Adults: The Mediating Role of Frailty

There is an association of hypertension and frailty with an increased risk of falls. Importantly, frailty may serve as a mediating factor in the relationship between hypertension and fall risk. It is known that frailty is a dynamic, reversible process rather than a fixed, unchangeable state. This implies that through early intervention and effective management strategies, frailty can be modulated in older adults with hypertension, thereby reducing their risk of falling. Currently, there is a lack of published studies examining the mediating effects of frailty on the relationship between hypertension and falls.

In this study, we aimed to examine the mediating role of frailty in the relationship between hypertension and fall risk among community-dwelling older adults.

This cross-sectional study involved 357 older adults from China. Data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, Spearman correlation analysis, and mediation analysis with the PROCESS macro.

Univariate analysis indicated that age, occupation, marital status, per capita monthly income, polypharmacy, the number of chronic diseases, and hypertension were significantly associated with risk of falls. Correlation analysis revealed a significant link between hypertension, fall risk, and frailty. After controlling for covariates, frailty was found to partially mediate the relationship between hypertension and fall risk, accounting for 21.60% of the relationship.

Frailty played a mediating role in the connection between hypertension and fall risk. Since frailty is a modifiable factor, interventions aimed at reducing frailty should be developed and tested to determine if they could positively influence fall risk among older individuals with hypertension in the community.