The Socioeconomic Burden of Fall-Related Injuries Among Community-Dwelling Older Adults: A Cross-Sectional Survey
DOI:
https://doi.org/10.63516/amss/03.01/004Keywords:
Aging, Community-Dwelling, Disability, Fear of FallingAbstract
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.
References
Alamri, S., Ghamri, R., Alshehri, W., Alhuthayli, R., Alamoudi, N., Alnufaei, R., & Alkeridy, W. (2023). Falls and correlations among community-dwelling older adults: A cross-sectional study in Jeddah, Saudi Arabia. Pakistan Journal of Medical Sciences, 39(1). https://doi.org/10.12669/pjms.39.1.6993
Bashir, S., Kishwar, S., Nasir, M., & Ali, S. (2024). Socioeconomic inequalities in out-of-pocket and catastrophic health expenditures in Pakistan. International Journal of Public Health, 69, Article 1607313. https://doi.org/10.3389/ijph.2024.1607313
Bibi, R., Yan, Z., Ilyas, M., Shaheen, M., Singh, S. N., & Zeb, A. (2023). Assessment of fall-associated risk factors in the Muslim community-dwelling older adults of Peshawar, Khyber Pakhtunkhwa, Pakistan. BMC Geriatrics, 23, Article 623. https://doi.org/10.1186/s12877-023-04322-1
Chen, Y., Dai, F., Huang, S., et al. (2025). Global, regional, and national burden of falls among older adults: Findings from the Global Burden of Disease Study 2021 and projections to 2040. npj Aging, 11, Article 85. https://doi.org/10.1038/s41514-025-00275-4
Federici, S., Bracalenti, M., Meloni, F., & Luciano, J. V. (2016). World Health Organization disability assessment schedule 2.0: An international systematic review. Disability and Rehabilitation, 39(23), 2347–2380. https://doi.org/10.1080/09638288.2016.1223177
Garin, O., Ayuso-Mateos, J. L., Almansa, J., Nieto, M., Chatterji, S., Vilagut, G., Alonso, J., Cieza, A., Svetskova, O., Burger, H., Racca, V., Francescutti, C., Vieta, E., Kostanjsek, N., Raggi, A., Leonardi, M., & Ferrer, M. (2010). Validation of the "World Health Organization Disability Assessment Schedule, WHODAS-2" in patients with chronic diseases. Health and Quality of Life Outcomes, 8, Article 51. https://doi.org/10.1186/1477-7525-8-51
Heinrich, S., Rapp, K., Rissmann, U., Becker, C., & König, H.-H. (2010). Cost of falls in old age: A systematic review. Osteoporosis International, 21(6), 891–902. https://doi.org/10.1007/s00198-009-1100-1
Izadi-Avanji, F. S., Safa, A., Abedzadeh-Kalahroudi, M., & Shaterian, N. (2024). Fear of falling and its related factors in older adults following a fall in Kashan, Iran (2023–2024). BMC Geriatrics, 24, Article 965. https://doi.org/10.1186/s12877-024-05560-7
Nazir, S., Mathiyakom, W., Tassawar, M. A., & Tantisuwat, A. (2025). Barriers to reporting fear of falling and participation in fall prevention strategies among older adults in Pakistan: A qualitative study. BMC Geriatrics, 25, Article 837. https://doi.org/10.1186/s12877-025-06555-8
Sanders, K. M., Stuart, A. L., Scott, D., Kotowicz, M. A., & Nicholson, G. C. (2015). Validity of 12-month falls recall in community-dwelling older women participating in a clinical trial. International Journal of Endocrinology, 2015, Article 210527. https://doi.org/10.1155/2015/210527
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2019(1), Article CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2020). Exercise for preventing falls in older people living in the community: An abridged Cochrane systematic review. British Journal of Sports Medicine, 54(15), 885–891. https://doi.org/10.1136/bjsports-2019-101512
Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., Saxena, S., von Korff, M., & Pull, C. (2010). Developing the World Health Organization Disability Assessment Schedule 2.0. Bulletin of the World Health Organization, 88(11), 815–823. https://doi.org/10.2471/BLT.09.067231
World Health Organization. (2007). WHO global report on falls prevention in older age. https://www.who.int/publications/i/item/9789241563536
World Health Organization. (2021, April 26). Falls [Fact sheet]. https://www.who.int/news-room/fact-sheets/detail/falls
Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C., & Todd, C. (2005). Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age and Ageing, 34(6), 614–619. https://doi.org/10.1093/ageing/afi196
Zijlstra, G. A. R., van Haastregt, J. C. M., van Eijk, J. Th. M., & Kempen, G. I. J. M. (2005). Evaluating an intervention to reduce fear of falling and associated activity restriction in elderly persons: Design of a randomised controlled trial [ISRCTN43792817]. BMC Public Health, 5, Article 26. https://doi.org/10.1186/1471-2458-5-26
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Archives of Management and Social Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.


