Osteoarthritis diagnosis not independently linked to recurrent falls in OAI cohort study

BackgroundOsteoarthritis (OA), the most prevalent joint disease, is associated with impaired mobility and may contribute to fall risk in older adults. Recurrent falls (≥two falls/year) are of particular concern due to their impact on morbidity and independence. This study is the first to examine whether individuals with early hip and/or knee OA are at increased risk of recurrent falls within 12 months of diagnosis and to identify biopsychosocial factors associated with fall risk.MethodsData were derived from the Osteoarthritis Initiative (OAI), a retrospective cohort of 4,427 participants stratified into four groups: individuals without OA, with knee OA, with hip OA, and with combined hip and knee OA. Self-reported recurrent falls within 12 months post-diagnosis were analyzed. Correlation and multivariable logistic regression analyses were conducted to identify predictive factors and interactions.ResultsThe presence of OA alone was not independently associated with recurrent falls in short term. However, multivariable logistic regression identified several factors associated with recurrent falls. There was a trend toward increased odds among participants with hip OA (OR = 2.35, p = 0.062). Individuals under 65 years had lower odds of recurrent falls compared to older adults (OR = 0.752, p = 0.034), and better physical function was protective (SF-12: OR = 0.980, p = 0.005). Depressive symptoms were associated with increased odds (CES-D: OR = 1.024 per point, p = 0.005). Interaction analysis showed that depression particularly increased recurrent falls risk in those with knee OA (OR = 1.036, p = 0.034), while younger age was protective among individuals with hip OA (OR = 0.230, p = 0.036).ConclusionsWhile Osteoarthritis itself does not directly predict recurrent falls in short term, its risk in individuals with OA is shaped by a multifactorial interplay of age, marital status, ethnicity, physical functioning, and depressive symptoms, with specific interactions involving OA location. Therefore, a differentiated assessment and multidisciplinary approach addressing these factors are essential to reduce recurrent falls in this population.