Risk of fall-related emergency department visits following impaired intrinsic capacity among community older adults in Taiwan.

BACKGROUND

Intrinsic capacity (IC) reflects composite physical and mental capacities of aging populations. This study examined associations between IC impairments, severity, and patterns with fall-related emergency department (ED) visits in Taiwan.

METHODS

We conducted a population-based cohort study using Taiwan's Integrated Care for Older People (ICOPE) database linked to National Health Insurance claims and Death Registry. A total of 244,899 adults aged ≥65 years were followed from 2022 to 2023. Six IC domains (cognition, mobility, vitality, vision, hearing, and psychological well-being) were assessed. IC levels was categorized as high (0 impairments), moderate (1-2), or low (≥3). Latent class analysis (LCA) identified IC impairment patterns. Poisson regression estimated rate ratios (RRs), adjusting for confounders.

RESULTS

Over 213,528 person-years, 1485 fall-related ED visits occurred among 1375 participants (fall-related ED visit rate: 6.95 visits per 1000 person-years). Impairments in cognition (aRR = 1.23, 95% CI: 1.03-1.47), mobility (aRR = 1.58, 95% CI: 1.37-1.82), and vision (aRR = 1.20, 95% CI: 1.07-1.36) were independently associated with increased fall risk. Compared with high IC, moderate and low IC were associated with progressively higher risks of fall-related ED visits. LCA identified five IC patterns; the highest risk occurred in the physio-cognitive decline with sensory impairment (aRR = 1.87, 95% CI: 1.60-2.19), followed by all-domain impairments (aRR = 1.81, 95% CI: 1.29-2.54) and nutritional-visual-physical impairments (aRR = 1.53, 95% CI: 1.12-2.09).

CONCLUSIONS

IC impairments, severity, and patterns independently predicted fall-related ED visits. Integrating ICOPE screening into primary care may enhance fall prevention strategies.