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Description

Abstract Purpose: Falls in older adults significantly affect mobility, independence, and quality of life. Fear of falling affects nearly half of older adults, including those without prior falls. Pain, reported by approximately 18.7 million U.S. older adults, contributes to reduced activity and has been linked to fear of falling through mobility limitation, psychological effects, and balance impairment. Despite this, nationally representative studies examining postoperative fall risk and functional recovery across hip, knee, and spine surgeries remain limited. This study examines associations between surgery history, demographic and socioeconomic factors, fall risk, and functional recovery among older adults. Methods: This cross-sectional study analyzed data from Round 13 of the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries aged 65 and older. Data were collected through in-person interviews in 2024, representing 2023–2024 experiences (n = 8,597). Surgery type was categorized as hip, knee, spine, or combined procedures. Full activities of daily living (ADL) independence was defined as independence in all assessed ADLs. Logistic regression examined associations between demographic, socioeconomic, and surgical predictors and full ADL independence. Proportional odds and Poisson regression models assessed ordered and count-based ADL outcomes. Analyses were conducted in R. Results: In survey-weighted analyses, site-specific pain was strongly associated with corresponding recent surgery, with knee pain predicting knee surgery, hip pain predicting hip surgery, and back and neck pain predicting spine surgery (p < 0.05). After adjusting for pain at each site, FOF was not associated with knee surgery, but was significantly associated with hip and spine surgery across multiple pain locations. In individuals who had hip, spine, or knee surgery, there was no significant association between FOF and assistance required for ADLs, suggesting that FOF may reflect perceived vulnerability rather than actual functional dependence.

Conclusions: The findings indicate the importance of including FOF as a method of postoperative risk assessment. Further research is needed to explore if interventions targeting FOF can improve postoperative rehabilitation. Building on this study, future analyses will examine additional ADLs and associations across various demographic subgroups.

Keywords

Pain, Fear of Falling

Document Type

Poster

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Comparing Fall Risk and Functional Recovery after Hip, Knee, or Spine Surgery in Older Adults

Abstract Purpose: Falls in older adults significantly affect mobility, independence, and quality of life. Fear of falling affects nearly half of older adults, including those without prior falls. Pain, reported by approximately 18.7 million U.S. older adults, contributes to reduced activity and has been linked to fear of falling through mobility limitation, psychological effects, and balance impairment. Despite this, nationally representative studies examining postoperative fall risk and functional recovery across hip, knee, and spine surgeries remain limited. This study examines associations between surgery history, demographic and socioeconomic factors, fall risk, and functional recovery among older adults. Methods: This cross-sectional study analyzed data from Round 13 of the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries aged 65 and older. Data were collected through in-person interviews in 2024, representing 2023–2024 experiences (n = 8,597). Surgery type was categorized as hip, knee, spine, or combined procedures. Full activities of daily living (ADL) independence was defined as independence in all assessed ADLs. Logistic regression examined associations between demographic, socioeconomic, and surgical predictors and full ADL independence. Proportional odds and Poisson regression models assessed ordered and count-based ADL outcomes. Analyses were conducted in R. Results: In survey-weighted analyses, site-specific pain was strongly associated with corresponding recent surgery, with knee pain predicting knee surgery, hip pain predicting hip surgery, and back and neck pain predicting spine surgery (p < 0.05). After adjusting for pain at each site, FOF was not associated with knee surgery, but was significantly associated with hip and spine surgery across multiple pain locations. In individuals who had hip, spine, or knee surgery, there was no significant association between FOF and assistance required for ADLs, suggesting that FOF may reflect perceived vulnerability rather than actual functional dependence.

Conclusions: The findings indicate the importance of including FOF as a method of postoperative risk assessment. Further research is needed to explore if interventions targeting FOF can improve postoperative rehabilitation. Building on this study, future analyses will examine additional ADLs and associations across various demographic subgroups.