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Purpose <p>To examine the association between delirium and in-hospital falls in older adults, including fall occurrence and number of falls, and to assess whether fall-related factors differ according to delirium status.</p> Methods <p>We conducted a retrospective cohort study of patients aged ≥ 65 years hospitalized in acute geriatric units between 2022 and 2024. Delirium was identified using ICD-10 codes, Confusion Assessment Method (CAM) documentation, and physician-entered diagnoses. Fall occurrence (≥ 1 fall) was analysed using multivariable logistic regression and number of falls using negative binomial regression. Analyses were stratified according to delirium status.</p> Results <p>Among 12,866 hospitalizations, 1751 patients (13.6%) experienced at least one in-hospital fall. Delirium occurred in 2889 patients (22.5%) and was independently associated with fall occurrence (OR 1.51, 95% CI 1.32–1.72). Male sex (OR 1.56, 95% CI 1.39–1.74), Parkinson’s disease (OR 1.52, 95% CI 1.23–1.89), and antipsychotic exposure were also associated with falls. Baseline functional status showed a significant interaction with delirium status (p = 0.0002): higher functional independence was associated with lower fall risk in patients without delirium (OR per 10-point FIM increase 0.91, 95% CI 0.89–0.94), but not in those with delirium (OR 0.99, 95% CI 0.95–1.03). Delirium was also independently associated with a higher fall count (IRR 1.47, 95% CI 1.31–1.66).</p> Conclusion <p>Delirium is independently associated with both the occurrence and number of in-hospital falls. Once delirium develops, fall risk appears to reflect a state of acute neurocognitive instability in which baseline functional status loses much of its discriminative value for risk stratification.</p>

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Delirium and in-hospital falls in older adults: factors associated with fall occurrence and number of falls

  • 期刊论文

  • 发表日期：

    2026年4月20日

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  • Justine Falciola,
  • Christophe Graf,
  • Aline Mendes

摘要

Purpose

To examine the association between delirium and in-hospital falls in older adults, including fall occurrence and number of falls, and to assess whether fall-related factors differ according to delirium status.

Methods

We conducted a retrospective cohort study of patients aged ≥ 65 years hospitalized in acute geriatric units between 2022 and 2024. Delirium was identified using ICD-10 codes, Confusion Assessment Method (CAM) documentation, and physician-entered diagnoses. Fall occurrence (≥ 1 fall) was analysed using multivariable logistic regression and number of falls using negative binomial regression. Analyses were stratified according to delirium status.

Results

Among 12,866 hospitalizations, 1751 patients (13.6%) experienced at least one in-hospital fall. Delirium occurred in 2889 patients (22.5%) and was independently associated with fall occurrence (OR 1.51, 95% CI 1.32–1.72). Male sex (OR 1.56, 95% CI 1.39–1.74), Parkinson’s disease (OR 1.52, 95% CI 1.23–1.89), and antipsychotic exposure were also associated with falls. Baseline functional status showed a significant interaction with delirium status (p = 0.0002): higher functional independence was associated with lower fall risk in patients without delirium (OR per 10-point FIM increase 0.91, 95% CI 0.89–0.94), but not in those with delirium (OR 0.99, 95% CI 0.95–1.03). Delirium was also independently associated with a higher fall count (IRR 1.47, 95% CI 1.31–1.66).

Conclusion

Delirium is independently associated with both the occurrence and number of in-hospital falls. Once delirium develops, fall risk appears to reflect a state of acute neurocognitive instability in which baseline functional status loses much of its discriminative value for risk stratification.