Rehabilitation Services Use of Older Adults According to Fall-Risk Screening Guidelines

Abstract

Objectives: To characterize rehabilitation services use of older adults according to fall-risk classification based on screening guidelines. Design: Cross-sectional analysis of 2015 National Health and Aging Trends Study. Setting: Study participants' homes. Participants: National sample of 7,440 community-dwelling Medicare beneficiaries. Measurements: In-person interviews and functional assessments. Based on Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths and Injuries criteria, participants were classified as low, moderate, or high fall risk. Results: Twenty-three percent of older adults classified as moderate fall-risk (n = 2602) and 40.6% of those at high fall-risk (n = 940) reported rehabilitation services use in the past year. Among older adults who reported rehabilitation services in the past year (n = 1,505), treatment to address falls was reported by 2.8%, 12.6%, and 34.7% of those classified with low, moderate, and high fall-risk, respectively (p < 0.001). Older adults with high fall-risk who did not receive rehabilitation services had significantly better self-reported physical capacity (p = 0.02) but comparable physical performance (all p's > 0.05) relative to those who received rehabilitation. Conclusion: Older adults at high risk for falls were significantly more likely to report rehabilitation services use compared to those with low and moderate risk of falling. The findings also indicate that there is low adherence to national clinical recommendations for rehabilitation services use in older adults vulnerable to falls-related injury. Among the high fall-risk group, those who did not receive rehabilitation services had similarly low physical function as compared with those who received rehabilitation, indicating potential unmet need to address physical impairments related to fall-risk. J Am Geriatr Soc 67:100–107, 2019.