Falling once, falling again? Recurrence of home falls-related injuries among older adults in France.

backgroundUnintentional home and leisure injuries (HLIs) are a leading cause of morbidity and mortality among older adults, with falls representing the main source of harm. In France, as in many countries, the recurrence of such injuries has received limited attention, despite their major health and social consequences.

methodsWe conducted a prospective cohort study using data from the French MAVIE cohort, which continuously collects information on household characteristics, socio-demographics, health conditions, and injuries among older adults. We applied duration models with selection correction to estimate both the probability of sustaining an HLI and the time interval until injury recurrence, accounting for previous injuries and unobserved heterogeneity.

resultsAmong 2,179 participants aged 65 and older (mean age = 69.9 years; 57.2% female), 463 experienced at least one HLI during follow-up, resulting in 652 events. Low-income status, living alone, poor health, and a history of severe trauma (defined as injuries requiring medical attention) were associated with a higher probability of HLI. Regarding recurrence, the risk was influenced primarily by the nature of the previous injury. Seeking medical attention after an HLI was associated with a longer interval to recurrence, whereas the cumulative number of severe past injuries increased the likelihood of a faster recurrence.

conclusionsOur findings highlight that prior severe injury predicted subsequent HLIs: a history of severe trauma significantly raises the probability of subsequent HLIs. Prevention strategies should prioritize avoiding the first severe injury, promoting the use of walking aids, and improving home safety conditions. Tailored interventions addressing frailty and living environments are crucial for reducing injury recurrence among older adults.