The Socioeconomic Burden of Fall-Related Injuries Among Community-Dwelling Older Adults: A Cross-Sectional Survey

Abstract

This cross-sectional descriptive study aimed to assess the socioeconomic burden of fall-related injuries among 384 community-dwelling older adults (aged≥60 years) in Karachi and Hyderabad, Sindh, Pakistan. A structured questionnaire was used to collect data and included a fall history and cost-of-injury form, as well as the Falls Efficacy Scale-International (FES-I) and WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). The mean total direct cost per fall-related injury was PKR 42,316 ± 28,704, and 61.2% of those injured reported losing household income due to their injury and being unable to work. 58.3% of participants reported moderate to high fear of falling, and 34.6% reported moderate to severe disability on WHODAS 2.0. Significant positive correlations were found between fall-related cost burden and disability scores (rs = 0.487, p < 0.001) and fear of falling (rs = 0.411, p < 0.001) with Spearman’s correlation. In contrast, a moderate positive correlation was observed between fall-related cost burden and functional status (rs = 0.411, p < 0.001). Fall-related financial burden and fear of falling were found to be significant predictors of functional disability in older adults in regression analysis. Participants from lower-income households bore a greater cost burden and reported greater dependence on care than participants from higher-income households. The results indicated that community-based falls prevention programs and financial protection mechanisms are needed to minimize the socioeconomic burden of falls among the aged population in Pakistan.