Research paperFactors associated with the night-time index fall in an older hip fracture population

PurposeWe examined factors associated with the night-time index fall in a population-based sample of hip fracture patients with a specific focus on the effect of nocturia and visits to the bathroom with falling at night.Material and methodsThe study population comprised 849 (69%) hip fracture patients aged 65 years and over. Data were collected by means of interviews. Age- and gender-adjusted and multivariate logistic regression analyses were used.ResultsOf these patients, 122 (14%) had fallen between midnight and 06:00. Of the night-time fallers, compared to the daytime fallers, 38% vs 9% had fallen on the way to the bathroom. Of these, 95% reported nocturia at least once. After adjusting for age and gender, age at least 90 years, taking 4-10 or more than 10 medications, reporting any nocturia or nocturia more than three times, fall on the way to the bathroom, non-independent mobility level and use of any walking aid were significantly associated with falling at night. In the multivariate analysis, having fallen on the way to the bathroom (OR 4.45; 95% CI 2.65-7.46), reporting nocturia more than three times (OR 2.44; 95% CI 1.15-5.16) and having non-independent mobility level (OR 1.84; 95% CI 1.08-3.11) remained significantly associated with falling in the night-time.ConclusionsFalling on the way to the bathroom, severe nocturia and mobility impairment were independently associated with night-time falls in older hip fracture patients. The findings offer insights into understanding night-time falls and into preventing of falls and fractures in the oldest and frailest older population.