Country Differences in Fall Risk Among Older Adults: A Comparative Study of India and the USA

TL;DR

This study compares fall risk among older adults in India and the USA, finding significant differences influenced by factors like education and gender.

Contribution

The study provides a novel cross-national comparison of fall risk factors among older adults in India and the USA.

Findings

Older adults in the USA have nearly three times higher odds of falling compared to those in India.

Higher education increases fall risk in the US but not in India, and gender differences in fall risk differ between the two countries.

Rural-living older adults face elevated fall risk in both countries, with particularly high risk in the US.

Abstract

Falls represent a critical health concern for older adults, with risk factors varying across socio-demographic and lifestyle contexts. Despite significant implications for public health, few studies have compared fall risk between older adults in different countries. This study examines how socio-economic status and socio-demographic factors influence fall risk among older adults (age 65+) in the U.S and India. Using a harmonized cross-sectional dataset we created using data drawn from the Longitudinal Ageing Study in India (LASI 2017-18) and the Health and Retirement Study (HRS, 2016 & 2018), we used logistic regression models to identify factors that predict fall risk, and interaction tests to evaluate if fall-related risk factors are moderated by country (i.e., USA vs. India). Results show that older adults in the USA have almost three times the odds of experiencing a fall compared to their counterparts in India (p < 0.001). Regarding moderators, we find that more years of education was associated with higher fall risk in the US (p < 0.001) (but not in India), and females have elevated risk of Falls in India (p < 0.001), but not in the US relative to their male counterparts. Although rural-living older adults face elevated fall risk in both countries, rural-living older adults in the US adults face particularly high risk of falling. We conclude with a discussion about implications for country-specific fall prevention strategies.