Malnutrition, Frailty, and High Fall Risk in Older Adults: Examining Their Interactive Effects in a Cross-Sectional...

Falls are a major public health concern for older adults, impacting health. Frailty and malnutrition are widely studied variables closely linked to fall risk. While the individual links of these factors with fall risk are known, their combined effects and quantitative relationships remain poorly understood. This study aimed to explore the interactive effects of malnutrition and frailty on fall risk among older adults.

This study involved the recruitment of 13,970 older adults from 10 communities, who were assessed using the frailty score, the Mini-Nutritional Assessment Scale, and the STEADI tool. Multiplicative interactions were calculated through logistic regression. Additive interactions were evaluated using the relative excess risk (RERI), attribution ratio (AP), and synergy index (SI).

24.1% of participants were identified as having high fall risk. Frailty and malnutrition each independently correlate with fall risk. Compared with participants who were non-frail and well-nourished, those with coexisting frailty and malnutrition had significantly higher odds of high fall risk (OR = 15.83, 95% CI: 11.77-21.28). A significant multiplicative interaction between frailty and malnutrition was confirmed (OR = 1.064, 95% CI: 1.047-1.082). Significant positive additive interaction was also identified: RERI = 1.58 (95% CI: 0.19-2.96), AP = 0.10 (95% CI: 0.01-0.19), and SI = 1.18 (95% CI: 1.02-1.36).

Frailty and malnutrition are correlated with high fall risk in older adults, with a modest positive interaction observed between the two conditions, offering empirical support for the development of comprehensive fall prevention and management strategies.