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Non-Fracture Fall Injuries and Long-Term Geriatric Consequences in Older Women and Men from a Cross-Cohort Study

Award Number: R01AG061136
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/15/2020
PERIOD OF PERFORMANCE END DATE: 12/31/2026

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Non-Fracture Fall Injuries and Long-Term Geriatric Consequences in Older Women and Men from a Cross-Cohort Study - Project Summary/Abstract The goal of this R01 application is to examine time trends for incident fall injuries in Medicare, including non- fracture fall injuries (NFFI) and fractures, across 20 years of cohort data and if changes in risk factors explains trends, and then to evaluate major geriatric outcomes subsequent to incident NFFI. Unlike osteoporotic fracture, NFFI - defined as fall injuries without fracture - are not treated as hallmarks of geriatric decline, particularly if the presenting injury is not severe (e.g., soft tissue injury). Our preliminary data found fall mortality in older adults increased substantially over the past several decades, with higher increases for the oldest cohorts. We will evaluate if this trend in fall mortality extends to non-fatal medically treated fall injuries over 20 years in several combined epidemiologic cohorts of older adults with overlapping time periods from 1998-2019. The Specific Aims are: 1) To examine time trends for incident fall injuries in Medicare, including NFFI and fractures, across 20 years of cohort data and if changes in risk factors over the time period explains trends; and 2) To determine if incident NFFI predict future inpatient hospitalizations, increased risk of SNF stays and mortality for up to 5 years after NFFI in women and men. In 4 pooled longitudinal cohorts (61% women, 33% minorities, 36% aged >80 years, 27% obese) with in-person exams of 4,653 men and 7,338 women, incident fall injuries will be identified from 5-10 years of self-reported questions and Medicare Fee for Service (FFS) Parts A and B claims. We hypothesize fall injury incidence will increase over time in the combined cohort of nearly 12,000 women and men, with increases higher at the oldest ages, and that overall fall injury incidence and NFFI incidence increases will be partially explained by risk factors of metabolic (e.g., obesity, diabetes, blood pressure) and neuromuscular function (strength, gait speed, chair stand speed) that we have identified in past work as novel risk factors for NFFI. We hypothesize that an estimated 1,867 incident NFFI will predict future inpatient hospitalizations, increased risk of SNF stays and mortality. Our validated approaches from past projects combine extensive cohort data across 20 years and linked Medicare claims to examine increasing trends in fall injuries, including clinical NFFI, as a significant public health issue in old age.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2025	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	000	5	12/19/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $454,922 )
2025	2025	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	000	5	12/20/2024	NON-COMPETING CONTINUATION	$417,788
2025	2025	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	001	5	7/23/2025	NON-COMPETING CONTINUATION	$37,134
														Subtotal = $454,922

Issue Date FY: 2024 ( Subtotal = $464,209 )
2024	2024	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	000	4	1/5/2024	NON-COMPETING CONTINUATION	$417,788
2024	2024	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	001	4	7/1/2024	NON-COMPETING CONTINUATION	$46,421
														Subtotal = $464,209

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2022	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	000	3	1/13/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $464,209 )
2022	2022	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	000	3	1/10/2022	NON-COMPETING CONTINUATION	$417,788
2022	2022	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Aging Research	001	3	5/2/2022	NON-COMPETING CONTINUATION	$46,421
														Subtotal = $464,209

Issue Date FY: 2021 ( Subtotal = $492,642 )
2021	2021	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Aging Research	000	2	2/3/2021	NON-COMPETING CONTINUATION	$492,642
														Subtotal = $492,642

Issue Date FY: 2020 ( Subtotal = $529,962 )
2020	2020	UNIVERSITY OF PITTSBURGH THE	3520 FIFTH AVE	PITTSBURGH	PA	15213	ALLEGHENY	USA	Aging Research	000	1	4/13/2020	NEW	$529,962
														Subtotal = $529,962

Grand Total All Awards = $2,405,944

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Non-Fracture Fall Injuries and Long-Term Geriatric Consequences in Older Women and Men from a Cross-Cohort Study

Award Number: R01AG061136

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/15/2020

PERIOD OF PERFORMANCE END DATE: 12/31/2026

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