Characteristics of Falls and Fear of Falling Among Older Malaysians with Coexisting Diabetes Mellitus and Knee Osteoarthritis: A cross sectional study

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M O A Alababseh1,2; A M Ibrahim1; S R Seow1; N H M Yahaya3; N Ahmad4; S Shahar1; M P Tan5; D K A Singh1; S Mat1

1.Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia; 2.Physiotherapy Programme, Faculty of Allied Medical Sciences, Isra University;3; Department of Orthopaedics and Traumatology, Faculty of Medicine, Unive

Scientific Research

SP - Diabetes

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Abstract

Introduction:
Falls and fear of falling (FOF) are leading contributors to disability and reduced quality of life among older adults, especially those with knee osteoarthritis (KOA) and diabetes mellitus (DM), conditions that impair balance, mobility, and confidence.

Method:
A cross-sectional study was conducted among 538 community-dwelling Malaysians aged ≥60 years with KOA, DM, or both. KOA was identified by physician diagnosis or the American College of Rheumatology criteria, and DM by fasting plasma glucose ≥7.0 mmol/L or self-report. Participants were categorized into KOA−DM−, KOA−DM+, KOA+DM−, and KOA+DM+. Data on falls within the past 12 months, timing, causes, and hospitalization were collected, while FOF was assessed using the Short Falls Efficacy Scale–International.

Results:
The mean age was 66.7 ± 5.95 years, and 25.4% reported at least one fall in the past year. Fall prevalence was highest among KOA+DM− (29.8%) and KOA+DM+ (29.4%) groups, while FOF was greatest in KOA+DM− (50.3%). Compared with KOA−DM−, both KOA+DM− (aOR = 2.26; 95% CI 1.22–4.02) and KOA+DM+ (aOR = 2.31; 95% CI 1.17–4.53) showed higher odds of falling, as well as greater FOF (aOR = 6.25; 95% CI 3.27–11.96; aOR = 4.85; 95% CI 2.41–9.80). Most falls occurred indoors, especially in kitchens and bathrooms, commonly in the morning, and were mainly due to slipping or tripping.

Conclusion:
Older adults with KOA, with or without DM, are at higher risk of falls and FOF. Targeted prevention focusing on home safety, mobility, and confidence-building may help reduce fall risk in this population.