We prospectively examined the role of economic status on subsequent falls and injurious falls among US elders. The Asset and Health Dynamics Survey (AHEAD), a nationally representative cohort of individuals 70 and older, determined self-reported income, net worth, housing, health insurance, co-morbidity, physical function, in addition to cognitive and depression index scores. All information, including fall history and injury, were determined at baseline (1993) and again after 2 years. Bivariate analyses found a higher incidence of falling and injury among persons with lower income, lower net worth, less health insurance coverage, lacking home ownership, and poor self-rated home quality. However, after adjustment for several health and functional status indicators, we found that most measures of economic status no longer predicted higher fall rates, with the exception of housing. All multivariate models retained age, race/ethnicity, physical function, cognition, comorbidity, and prior falling history. Poor self-rated housing quality (Adjusted RR=1.31, p=0.037), but no other economic factors predicted falls risk in multivariate models: important were depression, neurologic disease and sensory impairment. On the other hand, additional housing characteristics such as not living in a house (Adjusted RR=1.26, p=0.013) and poor self-rated housing quality (Adjusted RR=1.42, p=0.038) demonstrated increased risk of injurious falls. Our results suggest a causal pathway through which economic factors lead to higher rates of disability and depression, and that the impact of lower SES may also be operating through poorer housing quality.
Learning Objectives: 1. Identify major aspects of the Asset and Health Dynamics Survey. 2. Discuss the implications of major falls risk factors for government health insurance programs
Keywords: Aging, Social Inequalities
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.