The “Domino Effect”: Functional decline and increased social care requirements following a fall
| dc.contributor.author | Briggs, Robert | en |
| dc.contributor.author | Ward, Mark | en |
| dc.contributor.author | van der Velde, Nathalie | en |
| dc.contributor.author | Scarlett, Siobhan | en |
| dc.contributor.author | Hernandez, Belinda | en |
| dc.contributor.author | Romero-Ortuno, Roman | en |
| dc.contributor.author | Tysinger, Bryan | en |
| dc.contributor.author | May, Peter | en |
| dc.contributor.author | Ahern, Emer | en |
| dc.contributor.author | Kenny, Rose Anne | en |
| dc.contributor.funder | Atlantic Philanthropies | en |
| dc.contributor.funder | Health Research Board | en |
| dc.date.accessioned | 2026-10-23T09:59:47Z | |
| dc.date.available | 2026-10-23T09:59:47Z | |
| dc.date.issued | 2026-08 | en |
| dc.description.abstract | Objectives: Falls represent an important inflection point in later life, increasing the risk of future adverse outcomes. This study aims to examine the association between an index fall, that is, a fall in a participant with no recent history of falls, and subsequent change in functional status, requirements for social care, and falls-related health care utilization. Design: Longitudinal analysis of population-representative data. Setting and Participants: Participants (n = 2454) aged ≥65 years from waves 1 to 3 of The Irish Longitudinal Study on Aging. Methods: Index falls were those reported at wave 2 in participants with no falls reported at wave 1. Falls/fractures, functional status (activities of daily living), and social care (home care, home help, and meals on wheels) were assessed by self-report. Regression models assessed the independent relationship between index falls and outcomes of interest. Results: Twenty percent of participants (n = 493) reported an index fall. In participants who were functionally independent at baseline, an index fall was associated with functional impairment at 2-year follow-up (odds ratio [OR], 1.71; 95% CI, 1.19-2.47; P = .004). Almost 12% with index falls developed functional impairment. In those not requiring home care at baseline, an index fall was independently associated with an almost 3-fold higher likelihood of requiring home care (OR, 2.87; 95% CI, 1.38-5.97; P = .005) and a higher number of monthly home care hours (β = 0.76; 95% CI, 0.18-1.34; P = .010) at 2-year follow-up. Almost 12% with index falls required “new” social supports. An index fall was independently associated with future falls–related emergency department presentations (OR, 1.69; 95% CI, 1.14-2.49; P = .008), future fractures (OR, 1.52; 95% CI, 1.08-2.15; P = .018), but not more general practitioner visits during follow-up. Conclusions and Implications: This study demonstrates that even a single fall can signal a significant shift in the health and functional trajectories of community-dwelling older people, reinforcing the need for proactive and coordinated prevention strategies. | en |
| dc.description.status | Peer reviewed | en |
| dc.description.version | Published Version | en |
| dc.format.mimetype | application/pdf | en |
| dc.identifier.articleid | 106324 | en |
| dc.identifier.citation | Briggs, R. et al. (2026) “The ‘Domino Effect’: Functional Decline and Increased Social Care Requirements Following a Fall,” Journal of the American Medical Directors Association, 27(8), (6pp), https://doi.org/10.1016/j.jamda.2026.106324 | en |
| dc.identifier.doi | 10.1016/j.jamda.2026.106324 | en |
| dc.identifier.endpage | 6 | en |
| dc.identifier.issn | 1525-8610 | en |
| dc.identifier.issued | 8 | en |
| dc.identifier.journaltitle | Journal of the American Medical Directors Association | en |
| dc.identifier.startpage | 1 | en |
| dc.identifier.uri | https://hdl.handle.net/10468/19498 | |
| dc.identifier.volume | 27 | en |
| dc.language.iso | en | en |
| dc.publisher | Elsevier BV | en |
| dc.rights | © 2026, authors. Published by Elsevier Inc. on behalf of Post-Acute and Long-Term Care Medical Association. This is an open access article under the CC BY license | en |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en |
| dc.subject | Geriatric syndromes | en |
| dc.subject | Accidental falls | en |
| dc.subject | Home care services | en |
| dc.subject | Emergency service | en |
| dc.subject | Hospital | en |
| dc.subject | [CoMHOffice] | en |
| dc.subject | [Medicine] | en |
| dc.title | The “Domino Effect”: Functional decline and increased social care requirements following a fall | en |
| dc.type | Article (peer-reviewed) | en |
| dc.type | journal-article | en |
