Nutritional, Cognitive, and Functional Deficits, Frailty, and Quality of Life Associated with Fall Risk in Community-Dwelling Older Adults: A Cross-Sectional Study Conducted in Brazil

Introduction/Objective
Falls among older adults are a global health concern, affecting approximately 30% of the elderly and leading to physical and psychological harm. In Brazil, falls affect 13.6% of older adults, with a severe impact on 7.5% of cases, emphasizing the need for preventive actions, especially within Primary Health Care (PHC). Although mobility issues, medication use, and environmental factors are established fall risks, the roles of nutrition, cognitive and functional status, frailty, and quality of life (QoL) are less examined. This study aimed to assess the influence of these multifactorial health aspects on fall risk among older adults enrolled in a Brazilian PHC program.

Method
This cross-sectional study involved 257 older adults (≥60 years) registered in PHC in Santa Cruz, Rio Grande do Norte, from June 2023 to March 2024. Data were collected through structured interviews, using validated instruments to measure fall risk, nutritional and cognitive status, frailty, functionality, and QoL. Data analysis included Chi-square and Mann-Whitney tests for categorical and scalar data, respectively, with Odds Ratios (OR) calculated to identify risk factors. A significance level of 5% (p<0.05) was applied.

Results
Among participants, 39.7% were at risk of falling, with risk factors including nutritional deficits, frailty, and impaired cognition. Notably, preserved cognitive function (OR=5.27), the absence of frailty (OR=4.49), and good nutritional status were associated with lower fall risk. Functional independence and higher QoL in physical and functional domains also correlated with reduced fall risk.

Conclusion
Adequate nutrition, cognitive preservation, low frailty, and functional independence are protective factors against falls in older adults. Interventions targeting these areas could reduce fall risk, underscoring the value of a multidimensional approach in PHC. These findings support preventive strategies focusing on nutrition, cognitive monitoring, and functional training to enhance elderly well-being and safety in community settings.