Factors associated with the night-time index fall in an older hip fracture population

Abstract

PurposeWe examined factors associated with the night-time index fall in a population-based sample of hip fracture patients with a specific focus on the effect of nocturia and visits to the bathroom with falling at night. Material and methodsThe study population comprised 849 (69%) hip fracture patients aged 65 years and over. Data were collected by means of interviews. Age- and gender-adjusted and multivariate logistic regression analyses were used. ResultsOf these patients, 122 (14%) had fallen between midnight and 06:00. Of the night-time fallers, compared to the daytime fallers, 38% vs 9% had fallen on the way to the bathroom. Of these, 95% reported nocturia at least once. After adjusting for age and gender, age at least 90 years, taking 4–10 or more than 10 medications, reporting any nocturia or nocturia more than three times, fall on the way to the bathroom, non-independent mobility level and use of any walking aid were significantly associated with falling at night. In the multivariate analysis, having fallen on the way to the bathroom (OR 4.45; 95% CI 2.65–7.46), reporting nocturia more than three times (OR 2.44; 95% CI 1.15–5.16) and having non-independent mobility level (OR 1.84; 95% CI 1.08–3.11) remained significantly associated with falling in the night-time. ConclusionsFalling on the way to the bathroom, severe nocturia and mobility impairment were independently associated with night-time falls in older hip fracture patients. The findings offer insights into understanding night-time falls and into preventing of falls and fractures in the oldest and frailest older population.