Related Experiment Video
Updated: Jun 17, 2026
Design and Analysis for Fall Detection System Simplification
Published on: April 6, 2020
Relative contributions of modifiable risk factors to injurious fall prediction in older adults: A predictive
Tewodros Yosef1, Julie A Pasco2, Monica C Tembo3
1Deakin Institute for Mental and Physical Health and Clinical Translation (Deakin IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, 3220, Australia; School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia.
Background:
Falls are a cause of injury, disability, and decline among older adults. Accurate identification of individuals at risk is essential; however, the contribution of modifiable risk factors to improving the prediction of injurious falls has not been evaluated. This study aimed to quantify the contributions of modifiable risk factors to predicting injurious falls.
Methods:
This secondary analysis included 952 participants aged ≥65 years from the Geelong Osteoporosis Study. Injurious falls were identified through linkage with the Victorian Emergency Minimum Dataset. Time to first injurious fall was analysed using Cox regression to assess the incremental contribution of predictors to model discrimination. Predictors were sequentially added according to clinical modifiability, and performance was evaluated using Harrell's C-index and Somers' D. The referent model included age, sex, mobility status, assistive device use, and Timed Up and Go test performance.
Results:
The referent model demonstrated moderate discrimination for injurious falls (Harrell's C = 0.682). Sequential addition of modifiable predictors improved model performance. Diuretic use (ΔC = 0.035, 95% CI: 0.008-0.061) and hip abductor strength (ΔC = 0.030, 95% CI: 0.002-0.057) produced the largest gains, followed by smoking (ΔC = 0.021, 95% CI: 0.010-0.032). Polypharmacy and modified fall efficacy scale scores had minimal impact, while alcohol consumption and antipsychotic use slightly reduced the C-index.
Conclusion:
Hip abductor strength and diuretic use contributed most strongly to predicting injurious falls, with smoking showing a smaller contribution. These findings support prioritising muscle strengthening, medication management, and targeted lifestyle interventions in multifactorial fall-prevention strategies.
