Discrepancies between Perceived and Physiological Fall Risks and Repeated Falls among Community-Dwelling Medicare Beneficiaries Aged 65 Years and Older

Objectives This study examined the associations of discrepancies between perceived and physiological fall risks with repeated falls. Methods We analyzed the 2016 Medicare Current Beneficiary Survey of 2,487 Medicare beneficiaries aged >= 65 years with >= 1 fall. The outcome variable was repeated falls (>= 2 falls), the key independent variable was a categorical variable of discrepancies between perceived (fear of falling) and physiological fall risks (physiological limitations), assessed using multivariate logistic regression. Results Among Medicare beneficiaries with >= 1 fall, 25.1% had low fear of falling but high physiological fall risk (Low Fear-High Physiological), 9.4% had high fear of falling but low physiological fall risk (High Fear-Low Physiological), 23.5% had low fear of falling and low physiological fall risks (Low Fear-Low Physiological), and 42.0% had high fear of falling and high physiological fall risks (High Fear-High Physiological). Having High Fear-High Physiological was associated with repeated falls (OR = 2.14; p < .001) compared to Low Fear-Low Physiological. Having Low Fear-High Physiological and High Fear-LowPhysiological were not associated with repeated falls. Conclusions Given that High Fear-High Physiological was associated with repeated falls and that many at-risk Medicare beneficiaries had High Fear-High Physiological, prevention efforts may consider targeting those most at-risk including Medicare beneficiaries with High Fear-High Physiological. Clinical Implications Assessing both perceived and physiological fall risks is clinically relevant, given it may inform targeted interventions for different at-risk Medicare beneficiaries among clinicians and other stakeholders.