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Risk of Accidental Falls Among Informal Caregivers.

Ayako Hiyoshi1,2, Katja Fall1,3, Scott Montgomery1,4,5

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Informal caregiving increases fall risk, particularly for those in lower-income households. While fatigue plays a role, most of the increased fall risk is a direct effect of caregiving tasks.

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Area of Science:

  • Gerontology
  • Public Health
  • Sociology

Background:

  • Informal caregiving has significantly increased in recent decades.
  • Caregivers may experience increased fall risk due to caregiving tasks and fatigue.
  • The specific association between personal caregiving at home and fall risk remains under-investigated.

Purpose of the Study:

  • To examine whether providing personal care to someone at home increases the risk of accidental falls.
  • To investigate potential mediating factors such as fatigue, sleep disturbances, and concentration difficulties.
  • To explore whether sociodemographic characteristics modify the relationship between caregiving and fall risk.

Main Methods:

  • Utilized longitudinal repeated measures data from 51,132 adults aged over 50 in 17 European countries (2004-2017).
  • Employed fixed-effects logistic models to compare fall risk during caregiving versus non-caregiving periods.
  • Controlled for time-varying variables and unmeasured time-invariant confounders, testing for effect modification and mediation.

Main Results:

  • Caregiving periods were associated with a 19% higher fall risk (OR 1.19) compared to non-caregiving periods.
  • This association was significantly modified by baseline household income; higher fall risk was observed in lower-income households (OR 1.36).
  • Fatigue, sleep problems, lower concentration, and behavioral changes jointly mediated only 12% of the increased fall risk, indicating a predominantly direct effect.

Conclusions:

  • Providing personal care at home is linked to an elevated risk of falls, especially among individuals in lower-income households.
  • The mediating role of fatigue and other psychological consequences of caregiving appears minimal.
  • Factors beyond fatigue, potentially related to living conditions like equipment and space, may contribute to the observed mechanisms linking caregiving to falls.