Risk Factors for Falls Among the Elderly in China: A Cross-Sectional Study

Risk Factors for Falls Among the Elderly in China: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Risk Factors for Falls Among the Elderly in China: A Cross-Sectional Study Nian Zhang, Dehua Li This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6612142/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Falls among the elderly are a significant public health concern. This study aims to explore and analyze the risk factors associated with falls among the elderly in China, in order to develop appropriate interventions to minimize fall risk. By using data from the China Health and Retirement Longitudinal Study, this study analyzes the incidence of falls and employs a logistic regression model to identify the influencing factors. A total of 8,170 samples were included in the analysis. Results show that the overall incidence of falls among the elderly is 18.29%. Being female, older age, poor self-rated health, depression, ADL difficulty, chronic diseases, physical pain, drinking, short sleep duration, dissatisfaction with life, and dissatisfaction with children were all significantly associated with a higher likelihood of falls. With the aging population accelerating, falls among the elderly are becoming increasingly serious, severely affecting their daily functioning and quality of life. Therefore, greater attention should be paid to these risk factors, and timely, targeted prevention and intervention strategies should be implemented to effectively reduce fall incidence. Health sciences/Risk factors Health sciences/Pathogenesis/Oncogenesis Health sciences/Medical research/Epidemiology Elderly Falls Influencing factors Risk factors China Introduction Falls among the elderly are recognized as a major public health issue [ 1 ]. According to the World Health Organization (WHO), a fall is defined as “an event which results in a person coming to rest inadvertently on the ground or a lower level.” Falls are the second leading cause of unintentional injury-related deaths globally [ 2 ], and finding effective strategies for fall prevention and intervention among the elderly has become a public health priority. China officially entered an aging society in the 21st century, and population aging has become one of the most pressing challenges facing the country’s social development. By the end of 2024, the number of people aged 60 and above in China had reached 310 million, with the aging rate rising from 19.8% in 2022 to 22% in 2024—an average annual increase of about one percentage point [ 3 ]. Given China's large population and rapid aging process, and based on an annual fall incidence estimate from WHO of 30% among adults over 60, more than 93 million elderly people in China are projected to experience at least one fall each year. As fall risk increases, it poses a disproportionate threat to the lives of both elderly men and women in China [ 4 ]. On one hand, the overall incidence of fall-related injuries among Chinese older adults remains at a moderate level [ 5 ]. On the other hand, among various causes of death, most fatal injuries among China’s elderly are attributable to falls, and the trend is on the rise [ 6 ]. The incidence of falls among the elderly constitutes a major public health challenge across diverse countries. A study based on data from the Survey of Health, Ageing and Retirement in Europe found fall incidence rates among the elderly to be 7.9% in Switzerland, 9.1% in Denmark, 9.4% in Sweden, 9.5% in Austria, 11% in Italy, 11.5% in the Netherlands, 11.8% in Germany, 12.8% in Belgium, 13.9% in Estonia, 14.9% in France, and 16.2% in both Spain and the Czech Republic [ 7 ]. In Canada, data from the Canadian Community Health Survey showed that 20% of community-dwelling elderly reported experiencing a fall [ 8 ]. Data from the Longitudinal Aging Study in India indicated a 12.5% fall incidence among the elderly [ 9 ]. In South Korea, data from the National Survey of Older Koreans indicated a fall rate of over 15% [ 10 ]. In China, research on falls among the elderly primarily focuses on specific regions or provinces, or is limited to either urban or rural areas. For instance, the fall incidence among the elderly was 20.65% in Shantou, Guangdong Province [ 11 ], 16.2% among community-dwelling elderly in Ningbo, Zhejiang Province [ 12 ], 18.5% in rural Jinxi, Jiangsu Province [ 13 ], 16.88% in rural areas of County M, Anhui Province [ 14 ], 41.5% in two communities in Beijing [ 15 ], and 13.1% in rural Shandong Province [ 16 ]. Due to the vast geographic span of China and the resulting disparities in socioeconomic development and local policy implementation, these findings reflect only localized patterns and cannot be generalized to the national elderly population. Moreover, international variation in fall incidence may be influenced by differing economic conditions and sociocultural environments. Therefore, the present study aims to investigate the prevalence of falls among the elderly in China using a nationally representative dataset. Fall-related injuries among the elderly are a major public health concern in both developed and developing countries [ 5 ]. These injuries can be either fatal or non-fatal, yet most lead to negative physical and psychological consequences. The physical effects of falls among the elderly commonly include soft tissue damage, dislocations, fractures, and prolonged pain [ 17 ]. Due to age-related physiological and functional decline, the elderly typically require a longer recovery period following fall-induced injuries. The psychological consequences often include loss of confidence, social isolation, and reduced participation in social activities [ 18 – 20 ], along with fear of falling [ 13 ] and lower life satisfaction [ 21 ]. Cognitive decline, reduced social support, and deteriorating health in the aging process may exacerbate psychological stress and emotional distress after a fall. Moreover, falls impose a substantial burden on families and society and place significant pressure on healthcare systems [ 8 ]. For example, after falling, the elderly often seek assistance and emotional support [ 22 ], which can physically and emotionally strain family caregivers [ 23 ], thereby increasing the overall burden [ 24 ]. The cost of fall-related injuries among the elderly accounts for approximately 0.85–1.5% of total healthcare expenditures in various countries, equating to 0.07–0.20% of GDP [ 25 ]. In the United States, falls among the elderly result in substantial medical expenses, costing approximately USD 50 billion annually [ 26 ]. In China, the cost per fall-related injury among the elderly ranges from USD 16 to USD 3,812 [ 27 ]. In short, the consequences of falls are multifaceted and interlinked. Short-term physical injuries may evolve into long-term disability. Financial burdens intensify family and societal pressures. Psychological trauma undermines emotional well-being. Altogether, these effects severely diminish the quality of life among the elderly. Falls among the elderly are typically caused by a combination of factors, including age, gender, chronic conditions, depression, living environment, and the use of certain medications [ 12 , 28 , 29 ]. However, many elderly people either fail to recognize or are unaware of their vulnerability, which increases the likelihood of such events [ 30 ]. Therefore, identifying the risk factors associated with falls is essential. This provides a solid theoretical foundation for developing targeted prevention and intervention strategies to reduce falls among the elderly in China, while also offering valuable insights that can help address similar challenges faced by aging populations globally. Data and Methods Data Source The data used in this study come from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS), released in 2023 by the National School of Development at Peking University. The CHARLS survey was designed with reference to a series of international aging studies, including the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), and the Survey of Health, Ageing and Retirement in Europe (SHARE). It adopted a multi-stage stratified probability proportional to size (PPS) sampling method. The CHARLS questionnaire covers various aspects of individual information, including family structure, health status and functioning, employment and retirement, and pension, providing detailed records of key characteristics of the elderly in China [ 31 ]. This offers a broad and precise micro-level data foundation for the present study. The CHARLS survey received approval from the Biomedical Ethics Review Committee of Peking University (Approval Number: IRB00001052-11015). Methods in this study were conducted in strict accordance with the Declaration of Helsinki and relevant local ethical guidelines and regulations. All participants in the CHARLS survey provided written informed consent before completing the interviews. Based on the research objectives, we selected elderly individuals aged 60 and above as the study population. After variable selection and data cleaning, a final sample of 8,170 elderly individuals was included, consisting of 4,105 males and 4,065 females. Variable Description The dependent variable is whether the elderly have experienced a fall. This is measured based on the survey question “Have you ever fallen?” Respondents who answered “Yes” were coded as 1, and those who answered “No” were coded as 0. Demographic variables include age, gender, place of residence, marital status, and education level. Age is grouped into three categories: 60–64, 65–69, and 70 years and above. Gender is categorized as male or female. Place of residence indicates whether the elderly live in rural or urban areas. Marital status is classified into two groups: with spouse and without spouse. Education level is divided into three categories based on the highest level completed: illiterate, junior high school or below, and high school or above. The health status variables include self-rated health, mental health, activities of daily living (ADL), chronic diseases, and physical pain. Self-rated health is measured based on the question "How would you rate your health?" and categorized into two groups: good and poor. Mental health is measured by the presence or absence of depression. The depression symptoms scale used in this study is the 10-item Center for Epidemiological Studies Depression Scale (CES-D10) [ 32 ], which has been validated in Chinese elderly respondents using CHARLS data [ 33 ], with high reliability and validity. According to the scoring rules of the Chinese version of CES-D10, the options "<1 day," "1–2 days," "3–4 days," and "5–7 days" are coded as 0, 1, 2, and 3, respectively, with reverse scoring for the items "I feel hopeful about the future" and "I am happy." The total score ranges from 0 to 30, with higher scores indicating more severe depression symptoms. Based on existing research on depression criteria [ 32 , 34 ], we define a CES-D10 score ≥ 10 as indicating the presence of depressive symptoms. In our study, the Cronbach's alpha for the depression scale is 0.7802. ADL are defined based on the respondent's difficulty in the following activities: dressing, bathing, eating, getting in and out of bed, using the toilet (e.g., squatting, standing), and controlling urination and defecation. Chronic disease status is measured by the number of chronic diseases diagnosed by a doctor for each respondent. Physical pain is measured based on the respondent's feedback regarding pain in different parts of their body. Behavioral variables include drinking, smoking, and sleep duration. Drinking behavior is assessed based on self-reported monthly alcohol consumption, while smoking is measured by current smoking status. Sleep duration refers to the respondent’s self-reported average number of hours of actual sleep per night over the past month. In addition, several other factors are considered, including life satisfaction, satisfaction with children, social activities, and household economic status. Life satisfaction is assessed based on the question “Overall, are you satisfied with your life?” and categorized as satisfied or dissatisfied. Satisfaction with children is measured by the question “Are you satisfied with your relationship with your children?” and similarly categorized. Social activity is determined by whether the respondent engaged in any social activities in the past month, such as visiting friends, playing mahjong, chess, or cards, or participating in community group activities. Household economic status is measured by whether any household member has ever been or is currently registered as part of the government’s officially designated poor households. The definitions of the demographic, health, behavioral, and other variables used in this study are shown in Table 1 . Table 1 Definition of variables Variable Definition Fall No = 0, Yes = 1 Gender Male = 0, Female = 1 Age 60–64 years = 1, 65–69 years = 2, 70 years and above = 3 Education level Illiterate = 1, Junior high school or below = 2, High school or above = 3 Marital status Without spouse = 0, With spouse = 1 Place of residence Rural = 0, Urban = 1 Self-rated health Good = 1, Poor = 2 Satisfaction with children Satisfied = 1, Dissatisfied = 2 Life satisfaction Satisfied = 1, Dissatisfied = 2 Social activity No = 0, Yes = 1 Depression No = 0, Yes = 1 ADL No difficulty = 0, Has difficulty = 1 Chronic disease No = 0, Yes = 1 Physical pain No = 0, Yes = 1 Sleep duration 7 hours or more = 0, Less than 7 hours = 1 Drinking No = 0, Yes = 1 Smoking No = 0, Yes = 1 Household Economic Status Non-poor household = 0, Poor household = 1 Statistical analysis This study first conducted descriptive statistics to summarize the basic characteristics of the sample population. Group comparisons were then performed based on whether the elderly experienced falls, and chi-square tests were used to assess the significance of differences. Subsequently, logistic regression analysis was employed to explore the influencing factors of falls among the elderly. The odds ratios (OR) and 95% confidence intervals (CI) from the logistic regression indicate the risk of falls associated with various characteristics. A p-value < 0.05 was considered statistically significant. Results Participant characteristics The basic characteristics of the elderly stratified by fall status are presented in Table 2 . The overall prevalence of falls among the elderly was 18.29%, with 7.12% among males and 11.16% among females. Details on the distribution of other characteristics are provided. Chi-square test results indicate that the differences in fall occurrence between groups for all included variables were statistically significant (P < 0.05). Table 2 Basic Characteristics of the Sample Population Falls (%) No Falls (%) P value Gender 0.000 Male 582(7.12%) 3523(43.12%) Female 912(11.16%) 3153(38.59%) Age 0.000 60–64 422(5.17%) 2396(29.33%) 65–69 502(6.14%) 2089(25.57%) ≥ 70 570(6.98%) 2191(26.82%) Education level 0.000 Illiterate 466(5.70%) 1652(20.22%) Junior high school or below 899(11.00%) 4251(52.03%) High school or above 129(1.58%) 773(9.46%) Marital status 0.000 Without spouse 351(4.30%) 1272(15.57%) With spouse 1143(13.99%) 5404(66.14%) Place of residence 0.019 Rural 1006(12.31%) 4281(52.40%) Urban 488(5.97%) 2395(29.31%) Self-rated health 0.000 Poor 646(7.91%) 1599(19.57%) Good 848(10.38%) 5077(62.14%) Life satisfaction 0.000 Dissatisfied 254(3.11%) 547(6.70%) Satisfied 1240(15.18%) 6129(75.02%) Satisfaction with children 0.000 Dissatisfied 146(1.79%) 295(3.61%) Satisfied 1348(16.50%) 6381(78.10%) Social activity 0.017 No 752(9.20%) 3587(43.90%) Yes 742(9.08%) 3089(37.81%) Depression 0.000 Yes 854(10.45%) 2490(30.48%) No 640(7.83%) 4186(51.24%) ADL 0.000 Has difficulty 716(8.76%) 1450(17.75%) No difficulty 778(9.52%) 5226(63.97%) Chronic disease 0.000 Yes 719(8.80%) 2564(31.38%) No 775(9.49%) 4112(50.23%) Physical pain 0.000 Yes 1158(14.17%) 3678(45.02%) No 336(4.11%) 2998(36.70%) Sleep duration 0.000 <7 hours 1062(13.00%) 4063(49.73%) ≥ 7 hours 432(5.29%) 2613(31.98%) Drinking 0.000 Yes 493(6.03%) 2333(28.56%) No 1001(12.25%) 4343(53.16%) Smoking 0.000 Yes 308(3.77%) 1815(22.22%) No 1186(14.52%) 4861(59.50%) Household Economic Status 0.000 Poor household 277(3.39%) 966(11.82%) Non-poor household 1217(14.90%) 5710(69.89%) Risk factors for falls among the elderly The logistic regression results of risk factors for falls based on the entire elderly sample are shown in Table 3 . Regarding individual characteristics, female elderly had a higher risk of fall compared to male elderly (OR = 1.521, 95% CI: 1.301–1.779). There were significant differences in fall risk across age groups. Compared to elderly aged 60–64, those aged 65–69 (OR = 1.295, 95% CI: 1.115–1.505) and those aged 70 and above (OR = 1.363, 95% CI: 1.173–1.584) had a higher fall risk. Regarding health-related variables, elderly people with poor self-rated health had a higher risk of fall compared to those with good self-rated health (OR = 1.376, 95% CI: 1.201–1.577). Compared to elderly without depression, those with depression had a higher fall risk (OR = 1.272, 95% CI: 1.113–1.455). Elderly people with ADL difficulties had a higher fall risk compared to those without ADL difficulties (OR = 2.112, 95% CI: 1.850–2.410). Those with chronic diseases had a higher fall risk compared to those without chronic diseases (OR = 1.148, 95% CI: 1.017–1.296). Elderly people experiencing physical pain had a higher fall risk than those without physical pain (OR = 1.730, 95% CI: 1.498–1.997). In terms of behavioral factors, elderly people who reported drinking had a higher fall risk compared to non-drinkers (OR = 1.346, 95% CI: 1.171–1.547). Those with shorter sleep duration had a higher fall risk than those with longer sleep duration (OR = 1.197, 95% CI: 1.051–1.363). In addition, elderly people who were dissatisfied with life had a higher fall risk compared to those who were satisfied (OR = 1.255, 95% CI: 1.034–1.522), and those dissatisfied with their children had a higher fall risk than those who were satisfied (OR = 1.432, 95% CI: 1.125–1.822). Interestingly, elderly people who had participated in social activities in the past month had a higher fall risk than those who had not (OR = 1.183, 95% CI: 1.049–1.334). Other variables in our analysis were not significantly associated with fall risk. Table 3 Logistic Regression of Fall Risk Factors Among the Elderly OR 95% CI Gender Male Ref. Female 1.521*** 1.301–1.779 Age 60–64 Ref. 65–69 1.295*** 1.115–1.505 ≥ 70 1.363*** 1.173–1.584 Education level Illiterate Ref. Junior high school or below 0.991 0.860–1.143 High school or above 0.975 0.763–1.246 Marital status Without spouse Ref. With spouse 1.023 0.881–1.188 Place of residence Rural Ref. Urban 1.002 0.876–1.147 Self-rated health Healthy Ref. Unhealthy 1.376*** 1.201–1.577 Life satisfaction Satisfied Ref. Dissatisfied 1.255** 1.034–1.522 Satisfaction with children Satisfied Ref. Dissatisfied 1.432*** 1.125–1.822 Social activity No Ref. Yes 1.183*** 1.049–1.334 Depression No Ref. Yes 1.272*** 1.113–1.455 ADL No difficulty Ref. Has difficulty 2.112*** 1.850–2.410 Chronic disease No Ref. Yes 1.148** 1.017–1.296 Physical pain No Ref. Yes 1.730*** 1.498–1.997 Sleep duration ≥ 7 hours Ref. <7 hours 1.197*** 1.051–1.363 Drinking No Ref. Yes 1.346*** 1.171–1.547 Smoking No Ref. Yes 0.960 0.815–1.130 Household Economic Status Non-poor household Ref. Poor household 1.047 0.892–1.228 Discussion Based on CHARLS data, this study examines the incidence and main risk factors of falls among the elderly in China. Our findings reveal an overall fall rate of 18.29% among the elderly, consistent with a previous meta-analysis showing a median rate of 18% [ 35 ]. Compared to the fall rates among the elderly in other countries mentioned earlier, the incidence of falls among Chinese elderly is relatively high, underscoring the need for focused attention on this issue. Among demographic variables, we found that the risk of fall is higher among female elderly compared to their male counterparts, which is consistent with previous studies [ 15 ]. This may be due to the gradual decline in estrogen levels with age, making older females more susceptible to osteoporosis [ 36 , 37 ]. Additionally, the higher prevalence of arthritis among females [ 38 ], as well as the tendency of females to wear inappropriate footwear during certain activities [ 39 , 40 ], may further increase the risk of fall. Therefore, it is particularly important for female elderly to take preventive measures to avoid falls in daily life. In line with earlier findings [ 28 ], the risk of fall increases with age. This could be attributed to age-related physiological decline, including impaired gait stability, deteriorating vision and hearing, and lower limb injuries, all of which reduce the ability to perform daily activities and significantly heighten the risk of fall [ 12 , 41 , 42 ]. As aging continues, the elderly become increasingly frail and require greater care and attention. In terms of personal health-related variables, consistent with previous research [ 43 ], elderly individuals with poor self-rated health have a higher risk of fall. Self-reported health status is an important indicator of overall health [ 44 ] and typically reflects their physical functioning, balance ability, and muscle strength. Conversely, those who rate their health as poor often perceive themselves to be weaker in these areas, which increases their risk of fall. Depression is associated with a higher risk of fall among the elderly, consistent with earlier findings [ 43 , 45 ]. This may be because depressive symptoms can lead to psychomotor impairments, such as slower motor responses and reduced reaction time, which compromise balance and the ability to cope with environmental challenges [ 46 ]. Developing interventions that target depression may help reduce the risk of fall among the elderly. Elderly individuals with difficulties in ADL face a higher risk of fall, consistent with previous findings [ 47 ]. This is likely because fall risk is closely associated with ADL capacity [ 48 ]. Those with ADL difficulties often lack the ability to perform daily tasks independently and tend to have poorer balance and coordination, which may increase their likelihood of fall in daily life. The presence of chronic diseases has also been shown to elevate fall risk among the elderly [ 49 ], which is consistent with our findings. Recurrent symptoms associated with chronic diseases can negatively affect balance function [ 50 ]. For example, elderly individuals with diabetes or hypertension may experience neuropathy or blood pressure fluctuations, impairing their balance and increasing their risk of fall [ 51 , 52 ]. Moreover, elderly individuals experiencing physical pain are more likely to fall, which is consistent with previous research [ 28 ]. Pain is a common and debilitating health stressor that often limits daily activities [ 53 ], which may in turn increase vulnerability to falls. As for personal behavior-related factors, consistent with previous research [ 40 ], elderly individuals who drink have a higher risk of fall. This may be because alcohol consumption affects physiological functions and significantly impairs postural control, which is detrimental to balance [ 54 ]. Elderly drinkers are more sensitive to the coordination impairments caused by alcohol [ 55 ], thus increasing their fall risk. Elderly individuals with short sleep duration are at higher risk of fall, consistent with previous findings [ 56 ]. Sleep is a crucial factor for initiating or maintaining physical activity [ 57 ], and insufficient sleep can lead to poor mental state. Additionally, sleep problems may impair cognitive function and psychomotor performance, with significant associations found between sleep deprivation, slower gait speed, and dynamic instability [ 58 , 59 ], which increases fall risk. Regarding other associated variables, elderly individuals dissatisfied with their lives and children face a higher risk of fall. A key factor associated with elderly life satisfaction is family relationships [ 60 ]. Family serves as the most important bond in social life, providing individuals with a sense of belonging, security, and support. A lack of family support or dysfunctional family dynamics can lower life satisfaction, which often triggers negative emotions [ 61 ]. Negative emotions can affect the overall well-being of the elderly, increasing their fall risk. Furthermore, in China’s traditional family culture centered around filial piety, elderly individuals often exhibit strong emotional dependence on their children and high expectations. If intimate and reciprocal relationships are not established, this can lead to poor mental health and increase the fall risk. Children can improve parental satisfaction through economic [ 62 ] and emotional support [ 63 ], enhancing the psychological well-being of the elderly and reducing fall risk. It is noteworthy that social activities may increase the fall risk among elderly individuals, which contradicts previous studies [ 48 ]. This could be due to the fact that social activities in our sample mainly involved playing mahjong indoors, and prolonged sitting while playing may increase fatigue. Research has shown that fatigue is also a risk factor for falls [ 64 ], as mental fatigue can impair gait performance, thus increasing the likelihood of falls [ 65 ]. Conclusion Our study indicates that the incidence of falls among elderly people in China is relatively high. As China's population continues to age, the number of elderly individuals experiencing falls may further increase, leading to greater pressure and challenges for families and society. Identifying effective methods to prevent falls in the elderly has become a public health priority. Based on the factors influencing falls in the elderly, we recommend the following measures: increasing awareness of fall prevention, strengthening family support, developing community care services, improving physical and mental health for the elderly, promoting healthy lifestyles, and paying particular attention to female and the older elderly population. By implementing targeted, multi-dimensional strategies and interventions, the aim is to effectively reduce the incidence of falls in the elderly and promote healthy aging. Our study has several advantages. First, the main strength of this study lies in its use of a nationally representative sample, which provides rich data to support the reliability of our conclusions. Second, we examined a range of risk factors influencing falls among the elderly, which enhanced the comprehensiveness of our findings. Finally, our results not only provide valuable evidence for fall prevention among elderly people in China but also offer useful insights for other countries, particularly for developing nations, in formulating fall prevention and intervention strategies. However, this study has certain limitations. First, due to the use of cross-sectional data, the causal relationship between falls and related factors among the elderly cannot be established. Second, the 2020 CHARLS survey data was collected during the COVID-19 pandemic, and some factors related to falls (such as medication use, vision status, BMI, etc.) were not included in the survey, meaning their impact on falls among the elderly was not assessed. Finally, the information collected from participants was self-reported, which introduces a potential risk of recall bias. Declarations Data availability The datasets used and analysed during the current study are available from the corresponding author on reasonable request. Ethics approval and consent to participate No animal studies are presented in this manuscript. No potentially identifiable human images or data are presented in this study. Ethical approval for all the waves of the China Health and Retirement Longitudinal Study (CHARLS) was granted by the Institutional Review Board at Peking University. The IRB approval number is IRB00001052-11015. Consent to participate All the participants signed written informed consent forms prior to participating in the study. Competing interests The authors declare that they have no competing interests. Funding This study was funded by the Postgraduate Scientific Research Innovation Project of Hunan Province (Grant No. CX20240632) Authors' contributions N.Z. contributed to writing the original draft, formal analysis, validation and data curation. D.L. was responsible for conceptualization, writing review and editing, software, methodology, visualization and funding acquisition. 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The mortality trends of falls among the elderly adults in the mainland of China, 2013-2020: a population-based study through the National Disease Surveillance Points system. Lancet Reg. Health West. Pac. 19 , 100336 (2021). https://doi.org/10.1016/j.lanwpc.2021.100336 Wang, K. et al. The incidence of falls and related factors among Chinese elderly community residents in six provinces. Int. J. Environ. Res. Public Health 19 , 14843 (2022). https://doi.org/10.3390/ijerph192214843 Al-Hanawi, M. K. Self-reported health inequalities among older adults in Saudi Arabia. Healthcare 12 , 72 (2023). https://doi.org/10.3390/healthcare12010072 Gambaro, E., Gramaglia, C., Azzolina, D., Campani, D. & Molin, A. D. The complex associations between late life depression, fear of falling and risk of falls. a systematic review and meta-analysis. Ageing Res. Rev. 73 , 101532 (2022). https://doi.org/10.1016/j.arr.2021.101532 Song, J., Wu, X., Zhang, Y., Song, P. & Zhao, Y. Association between changes in depressive symptoms and falls: the China health and retirement longitudinal study (CHARLS). J. Affect. Disord. 341 , 393-400 (2023). https://doi.org/10.1016/j.jad.2023.09.004 Wu, H. & Ouyang, P. Fall prevalence, time trend and its related risk factors among elderly people in China. Arch. Gerontol. Geriatr. 73 , 294-299 (2017). https://doi.org/10.1016/j.archger.2017.08.009 Yokoya, T., Demura, S. & Sato, S. Relationships between physical activity, ADL capability and fall risk in community-dwelling Japanese elderly population. Environ. Health Prev. Med. 12 , 25-32 (2007). https://doi.org/10.1007/BF02898189 Nie, X. Y. et al. Multimorbidity patterns and the risk of falls among older adults: a community-based study in China. BMC Geriatr. 24 , 660 (2024). https://doi.org/10.1186/s12877-024-05245-1 Cameron, M. H. & Nilsagard, Y. Balance, gait, and falls in multiple sclerosis. Handb. Clin. Neurol. 159 , 237-250 (2018). https://doi.org/10.1016/B978-0-444-63916-5.00015-X Yang, Y., Hu, X., Zhang, Q. & Zou, R. Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis. Age Ageing 45 , 761-767 (2016). https://doi.org/10.1093/ageing/afw140 Gangavati, A. et al. Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J. Am. Geriatr. Soc. 59 , 383-389 (2011). https://doi.org/10.1111/j.1532-5415.2011.03317.x Fennell, G., Osuna, M., Ailshire, J. & Zajacova, A. Pain lowers subjective survival probabilities among middle-aged and older adults. J. Gerontol. B Psychol. Sci. Soc. Sci. 79 , gbae071 (2024). https://doi.org/10.1093/geronb/gbae071 Modig, F., Patel, M., Magnusson, M. & Fransson, P. A. Study I: effects of 0.06% and 0.10% blood alcohol concentration on human postural control. Gait Posture 35 , 410-418 (2012). https://doi.org/10.1016/j.gaitpost.2011.10.364 White, A. M., Orosz, A., Powell, P. A. & Koob, G. F. Alcohol and aging - an area of increasing concern. Alcohol 107 , 19-27 (2023). https://doi.org/10.1016/j.alcohol.2022.07.005 Zhu, C., Sun, J., Huang, Y. & Lian, Z. Sleep and risk of hip fracture and falls among middle-aged and older Chinese. Sci. Rep. 14 , 23273 (2024). https://doi.org/10.1038/s41598-024-74581-4 Wang, X. & Wang, H. A study on the relationship between health lifestyle behaviors of the elderly: taking sleep and physical activity as examples. Popul. J. 44 , 69-80 (2022). https://doi.org/10.16405/j.cnki.1004-129X.2022.06.006 Stevens, D. et al. The impact of obstructive sleep apnea on balance, gait, and falls risk: a narrative review of the literature. J. Gerontol. A Biol. Sci. Med. Sci. 75 , 2450-2460 (2020). https://doi.org/10.1093/gerona/glaa014 Serrano-Checa, R. et al. Sleep quality, anxiety, and depression are associated with fall risk factors in older women. Int. J. Environ. Res. Public Health 17 , 4043 (2020). https://doi.org/10.3390/ijerph17114043 Chai, H. W. & Jun, H. J. Relationship between ties with adult children and life satisfaction among the middle-aged, the young-old, and the oldest-old Korean adults. Int. J. Aging Hum. Dev. 85 , 354-376 (2017). https://doi.org/10.1177/0091415016685834 Lue, B. H., Chen, L. J. & Wu, S. C. Health, financial stresses, and life satisfaction affecting late-life depression among older adults: a nationwide, longitudinal survey in Taiwan. Arch. Gerontol. Geriatr. 50 , S34-S38 (2010). https://doi.org/10.1016/S0167-4943(10)70010-8 Wu, Y. et al. Financial transfers from adult children and depressive symptoms among mid-aged and elderly residents in China - evidence from the China health and retirement longitudinal study. BMC Public Health 18 , 882 (2018). https://doi.org/10.1186/s12889-018-5794-x Huang, F. & Fu, P. Intergenerational support and subjective wellbeing among oldest-old in China: the moderating role of economic status. BMC Geriatr. 21 , 252 (2021). https://doi.org/10.1186/s12877-021-02204-y Kim, Y. S. et al. Association of frailty with fall events in older adults: a 12-year longitudinal study in Korea. Arch. Gerontol. Geriatr. 102 , 104747 (2022). https://doi.org/10.1016/j.archger.2022.104747 Behrens, M. et al. Mental fatigue increases gait variability during dual-task walking in old adults. J. Gerontol. A Biol. Sci. Med. Sci. 73 , 792-797 (2018). https://doi.org/10.1093/gerona/glx210 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6612142","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":465109512,"identity":"c1ddf5af-f8da-4dc5-aeb3-22be189d9263","order_by":0,"name":"Nian Zhang","email":"","orcid":"","institution":"Xiangtan University","correspondingAuthor":false,"prefix":"","firstName":"Nian","middleName":"","lastName":"Zhang","suffix":""},{"id":465109513,"identity":"93c373f9-5676-4b30-bdb2-be0e9ba2720e","order_by":1,"name":"Dehua Li","email":"data:image/png;base64,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","orcid":"","institution":"Xiangtan University","correspondingAuthor":true,"prefix":"","firstName":"Dehua","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2025-05-07 12:38:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6612142/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6612142/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93593880,"identity":"b39a1906-1344-405d-835d-35eb36cc5ab9","added_by":"auto","created_at":"2025-10-15 13:17:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1065291,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6612142/v1/468d2807-346c-41a2-8422-638dcc4cca6a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Risk Factors for Falls Among the Elderly in China: A Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eFalls among the elderly are recognized as a major public health issue [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. According to the World Health Organization (WHO), a fall is defined as \u0026ldquo;an event which results in a person coming to rest inadvertently on the ground or a lower level.\u0026rdquo; Falls are the second leading cause of unintentional injury-related deaths globally [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], and finding effective strategies for fall prevention and intervention among the elderly has become a public health priority. China officially entered an aging society in the 21st century, and population aging has become one of the most pressing challenges facing the country\u0026rsquo;s social development. By the end of 2024, the number of people aged 60 and above in China had reached 310\u0026nbsp;million, with the aging rate rising from 19.8% in 2022 to 22% in 2024\u0026mdash;an average annual increase of about one percentage point [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Given China's large population and rapid aging process, and based on an annual fall incidence estimate from WHO of 30% among adults over 60, more than 93\u0026nbsp;million elderly people in China are projected to experience at least one fall each year. As fall risk increases, it poses a disproportionate threat to the lives of both elderly men and women in China [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. On one hand, the overall incidence of fall-related injuries among Chinese older adults remains at a moderate level [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. On the other hand, among various causes of death, most fatal injuries among China\u0026rsquo;s elderly are attributable to falls, and the trend is on the rise [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe incidence of falls among the elderly constitutes a major public health challenge across diverse countries. A study based on data from the Survey of Health, Ageing and Retirement in Europe found fall incidence rates among the elderly to be 7.9% in Switzerland, 9.1% in Denmark, 9.4% in Sweden, 9.5% in Austria, 11% in Italy, 11.5% in the Netherlands, 11.8% in Germany, 12.8% in Belgium, 13.9% in Estonia, 14.9% in France, and 16.2% in both Spain and the Czech Republic [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In Canada, data from the Canadian Community Health Survey showed that 20% of community-dwelling elderly reported experiencing a fall [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Data from the Longitudinal Aging Study in India indicated a 12.5% fall incidence among the elderly [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In South Korea, data from the National Survey of Older Koreans indicated a fall rate of over 15% [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In China, research on falls among the elderly primarily focuses on specific regions or provinces, or is limited to either urban or rural areas. For instance, the fall incidence among the elderly was 20.65% in Shantou, Guangdong Province [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], 16.2% among community-dwelling elderly in Ningbo, Zhejiang Province [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], 18.5% in rural Jinxi, Jiangsu Province [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], 16.88% in rural areas of County M, Anhui Province [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], 41.5% in two communities in Beijing [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], and 13.1% in rural Shandong Province [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Due to the vast geographic span of China and the resulting disparities in socioeconomic development and local policy implementation, these findings reflect only localized patterns and cannot be generalized to the national elderly population. Moreover, international variation in fall incidence may be influenced by differing economic conditions and sociocultural environments. Therefore, the present study aims to investigate the prevalence of falls among the elderly in China using a nationally representative dataset.\u003c/p\u003e \u003cp\u003eFall-related injuries among the elderly are a major public health concern in both developed and developing countries [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. These injuries can be either fatal or non-fatal, yet most lead to negative physical and psychological consequences. The physical effects of falls among the elderly commonly include soft tissue damage, dislocations, fractures, and prolonged pain [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Due to age-related physiological and functional decline, the elderly typically require a longer recovery period following fall-induced injuries. The psychological consequences often include loss of confidence, social isolation, and reduced participation in social activities [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], along with fear of falling [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] and lower life satisfaction [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Cognitive decline, reduced social support, and deteriorating health in the aging process may exacerbate psychological stress and emotional distress after a fall. Moreover, falls impose a substantial burden on families and society and place significant pressure on healthcare systems [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. For example, after falling, the elderly often seek assistance and emotional support [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], which can physically and emotionally strain family caregivers [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], thereby increasing the overall burden [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The cost of fall-related injuries among the elderly accounts for approximately 0.85\u0026ndash;1.5% of total healthcare expenditures in various countries, equating to 0.07\u0026ndash;0.20% of GDP [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In the United States, falls among the elderly result in substantial medical expenses, costing approximately USD 50\u0026nbsp;billion annually [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In China, the cost per fall-related injury among the elderly ranges from USD 16 to USD 3,812 [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In short, the consequences of falls are multifaceted and interlinked. Short-term physical injuries may evolve into long-term disability. Financial burdens intensify family and societal pressures. Psychological trauma undermines emotional well-being. Altogether, these effects severely diminish the quality of life among the elderly.\u003c/p\u003e \u003cp\u003eFalls among the elderly are typically caused by a combination of factors, including age, gender, chronic conditions, depression, living environment, and the use of certain medications [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. However, many elderly people either fail to recognize or are unaware of their vulnerability, which increases the likelihood of such events [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Therefore, identifying the risk factors associated with falls is essential. This provides a solid theoretical foundation for developing targeted prevention and intervention strategies to reduce falls among the elderly in China, while also offering valuable insights that can help address similar challenges faced by aging populations globally.\u003c/p\u003e"},{"header":"Data and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData Source\u003c/h2\u003e \u003cp\u003eThe data used in this study come from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS), released in 2023 by the National School of Development at Peking University. The CHARLS survey was designed with reference to a series of international aging studies, including the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), and the Survey of Health, Ageing and Retirement in Europe (SHARE). It adopted a multi-stage stratified probability proportional to size (PPS) sampling method. The CHARLS questionnaire covers various aspects of individual information, including family structure, health status and functioning, employment and retirement, and pension, providing detailed records of key characteristics of the elderly in China [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. This offers a broad and precise micro-level data foundation for the present study. The CHARLS survey received approval from the Biomedical Ethics Review Committee of Peking University (Approval Number: IRB00001052-11015). Methods in this study were conducted in strict accordance with the Declaration of Helsinki and relevant local ethical guidelines and regulations. All participants in the CHARLS survey provided written informed consent before completing the interviews.\u003c/p\u003e \u003cp\u003eBased on the research objectives, we selected elderly individuals aged 60 and above as the study population. After variable selection and data cleaning, a final sample of 8,170 elderly individuals was included, consisting of 4,105 males and 4,065 females.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eVariable Description\u003c/h3\u003e\n\u003cp\u003eThe dependent variable is whether the elderly have experienced a fall. This is measured based on the survey question \u0026ldquo;Have you ever fallen?\u0026rdquo; Respondents who answered \u0026ldquo;Yes\u0026rdquo; were coded as 1, and those who answered \u0026ldquo;No\u0026rdquo; were coded as 0.\u003c/p\u003e \u003cp\u003eDemographic variables include age, gender, place of residence, marital status, and education level. Age is grouped into three categories: 60\u0026ndash;64, 65\u0026ndash;69, and 70 years and above. Gender is categorized as male or female. Place of residence indicates whether the elderly live in rural or urban areas. Marital status is classified into two groups: with spouse and without spouse. Education level is divided into three categories based on the highest level completed: illiterate, junior high school or below, and high school or above.\u003c/p\u003e \u003cp\u003eThe health status variables include self-rated health, mental health, activities of daily living (ADL), chronic diseases, and physical pain. Self-rated health is measured based on the question \"How would you rate your health?\" and categorized into two groups: good and poor. Mental health is measured by the presence or absence of depression. The depression symptoms scale used in this study is the 10-item Center for Epidemiological Studies Depression Scale (CES-D10) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], which has been validated in Chinese elderly respondents using CHARLS data [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], with high reliability and validity. According to the scoring rules of the Chinese version of CES-D10, the options \"\u0026lt;1 day,\" \"1\u0026ndash;2 days,\" \"3\u0026ndash;4 days,\" and \"5\u0026ndash;7 days\" are coded as 0, 1, 2, and 3, respectively, with reverse scoring for the items \"I feel hopeful about the future\" and \"I am happy.\" The total score ranges from 0 to 30, with higher scores indicating more severe depression symptoms. Based on existing research on depression criteria [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], we define a CES-D10 score\u0026thinsp;\u0026ge;\u0026thinsp;10 as indicating the presence of depressive symptoms. In our study, the Cronbach's alpha for the depression scale is 0.7802. ADL are defined based on the respondent's difficulty in the following activities: dressing, bathing, eating, getting in and out of bed, using the toilet (e.g., squatting, standing), and controlling urination and defecation. Chronic disease status is measured by the number of chronic diseases diagnosed by a doctor for each respondent. Physical pain is measured based on the respondent's feedback regarding pain in different parts of their body.\u003c/p\u003e \u003cp\u003eBehavioral variables include drinking, smoking, and sleep duration. Drinking behavior is assessed based on self-reported monthly alcohol consumption, while smoking is measured by current smoking status. Sleep duration refers to the respondent\u0026rsquo;s self-reported average number of hours of actual sleep per night over the past month. In addition, several other factors are considered, including life satisfaction, satisfaction with children, social activities, and household economic status. Life satisfaction is assessed based on the question \u0026ldquo;Overall, are you satisfied with your life?\u0026rdquo; and categorized as satisfied or dissatisfied. Satisfaction with children is measured by the question \u0026ldquo;Are you satisfied with your relationship with your children?\u0026rdquo; and similarly categorized. Social activity is determined by whether the respondent engaged in any social activities in the past month, such as visiting friends, playing mahjong, chess, or cards, or participating in community group activities. Household economic status is measured by whether any household member has ever been or is currently registered as part of the government\u0026rsquo;s officially designated poor households. The definitions of the demographic, health, behavioral, and other variables used in this study are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDefinition of variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinition\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u0026thinsp;=\u0026thinsp;0, Female\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u0026ndash;64 years\u0026thinsp;=\u0026thinsp;1, 65\u0026ndash;69 years\u0026thinsp;=\u0026thinsp;2, 70 years and above =\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIlliterate\u0026thinsp;=\u0026thinsp;1, Junior high school or below =\u0026thinsp;2, High school or above =\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithout spouse\u0026thinsp;=\u0026thinsp;0, With spouse\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u0026thinsp;=\u0026thinsp;0, Urban\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-rated health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u0026thinsp;=\u0026thinsp;1, Poor\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfaction with children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u0026thinsp;=\u0026thinsp;1, Dissatisfied\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLife satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u0026thinsp;=\u0026thinsp;1, Dissatisfied\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial activity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo difficulty\u0026thinsp;=\u0026thinsp;0, Has difficulty\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSleep duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 hours or more\u0026thinsp;=\u0026thinsp;0, Less than 7 hours\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousehold Economic Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-poor household\u0026thinsp;=\u0026thinsp;0, Poor household\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThis study first conducted descriptive statistics to summarize the basic characteristics of the sample population. Group comparisons were then performed based on whether the elderly experienced falls, and chi-square tests were used to assess the significance of differences. Subsequently, logistic regression analysis was employed to explore the influencing factors of falls among the elderly. The odds ratios (OR) and 95% confidence intervals (CI) from the logistic regression indicate the risk of falls associated with various characteristics. A p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eParticipant characteristics\u003c/h2\u003e \u003cp\u003eThe basic characteristics of the elderly stratified by fall status are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The overall prevalence of falls among the elderly was 18.29%, with 7.12% among males and 11.16% among females. Details on the distribution of other characteristics are provided. Chi-square test results indicate that the differences in fall occurrence between groups for all included variables were statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBasic Characteristics of the Sample Population\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFalls (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Falls (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e582(7.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3523(43.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e912(11.16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3153(38.59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e422(5.17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2396(29.33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e65\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e502(6.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2089(25.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e570(6.98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2191(26.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e466(5.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1652(20.22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJunior high school or below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e899(11.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4251(52.03%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e129(1.58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e773(9.46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWithout spouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e351(4.30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1272(15.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWith spouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1143(13.99%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5404(66.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1006(12.31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4281(52.40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e488(5.97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2395(29.31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-rated health\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e646(7.91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1599(19.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e848(10.38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5077(62.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLife satisfaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254(3.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e547(6.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1240(15.18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6129(75.02%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSatisfaction with children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e146(1.79%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e295(3.61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1348(16.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6381(78.10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocial activity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e752(9.20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3587(43.90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e742(9.08%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3089(37.81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepression\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e854(10.45%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2490(30.48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e640(7.83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4186(51.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eADL\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHas difficulty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e716(8.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1450(17.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo difficulty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e778(9.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5226(63.97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e719(8.80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2564(31.38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e775(9.49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4112(50.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1158(14.17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3678(45.02%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e336(4.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2998(36.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSleep duration\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;7 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1062(13.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4063(49.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;7 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e432(5.29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2613(31.98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDrinking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e493(6.03%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2333(28.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1001(12.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4343(53.16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e308(3.77%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1815(22.22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1186(14.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4861(59.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHousehold Economic Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor household\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e277(3.39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e966(11.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-poor household\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1217(14.90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5710(69.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eRisk factors for falls among the elderly\u003c/h2\u003e \u003cp\u003eThe logistic regression results of risk factors for falls based on the entire elderly sample are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Regarding individual characteristics, female elderly had a higher risk of fall compared to male elderly (OR\u0026thinsp;=\u0026thinsp;1.521, 95% CI: 1.301\u0026ndash;1.779). There were significant differences in fall risk across age groups. Compared to elderly aged 60\u0026ndash;64, those aged 65\u0026ndash;69 (OR\u0026thinsp;=\u0026thinsp;1.295, 95% CI: 1.115\u0026ndash;1.505) and those aged 70 and above (OR\u0026thinsp;=\u0026thinsp;1.363, 95% CI: 1.173\u0026ndash;1.584) had a higher fall risk.\u003c/p\u003e \u003cp\u003eRegarding health-related variables, elderly people with poor self-rated health had a higher risk of fall compared to those with good self-rated health (OR\u0026thinsp;=\u0026thinsp;1.376, 95% CI: 1.201\u0026ndash;1.577). Compared to elderly without depression, those with depression had a higher fall risk (OR\u0026thinsp;=\u0026thinsp;1.272, 95% CI: 1.113\u0026ndash;1.455). Elderly people with ADL difficulties had a higher fall risk compared to those without ADL difficulties (OR\u0026thinsp;=\u0026thinsp;2.112, 95% CI: 1.850\u0026ndash;2.410). Those with chronic diseases had a higher fall risk compared to those without chronic diseases (OR\u0026thinsp;=\u0026thinsp;1.148, 95% CI: 1.017\u0026ndash;1.296). Elderly people experiencing physical pain had a higher fall risk than those without physical pain (OR\u0026thinsp;=\u0026thinsp;1.730, 95% CI: 1.498\u0026ndash;1.997).\u003c/p\u003e \u003cp\u003eIn terms of behavioral factors, elderly people who reported drinking had a higher fall risk compared to non-drinkers (OR\u0026thinsp;=\u0026thinsp;1.346, 95% CI: 1.171\u0026ndash;1.547). Those with shorter sleep duration had a higher fall risk than those with longer sleep duration (OR\u0026thinsp;=\u0026thinsp;1.197, 95% CI: 1.051\u0026ndash;1.363). In addition, elderly people who were dissatisfied with life had a higher fall risk compared to those who were satisfied (OR\u0026thinsp;=\u0026thinsp;1.255, 95% CI: 1.034\u0026ndash;1.522), and those dissatisfied with their children had a higher fall risk than those who were satisfied (OR\u0026thinsp;=\u0026thinsp;1.432, 95% CI: 1.125\u0026ndash;1.822). Interestingly, elderly people who had participated in social activities in the past month had a higher fall risk than those who had not (OR\u0026thinsp;=\u0026thinsp;1.183, 95% CI: 1.049\u0026ndash;1.334). Other variables in our analysis were not significantly associated with fall risk.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic Regression of Fall Risk Factors Among the Elderly\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.521***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.301\u0026ndash;1.779\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e65\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.295***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.115\u0026ndash;1.505\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.363***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.173\u0026ndash;1.584\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJunior high school or below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.991\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.860\u0026ndash;1.143\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.975\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.763\u0026ndash;1.246\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWithout spouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWith spouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.881\u0026ndash;1.188\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.876\u0026ndash;1.147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-rated health\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnhealthy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.376***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.201\u0026ndash;1.577\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLife satisfaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.255**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.034\u0026ndash;1.522\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSatisfaction with children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.432***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.125\u0026ndash;1.822\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocial activity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.183***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.049\u0026ndash;1.334\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepression\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.272***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.113\u0026ndash;1.455\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eADL\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo difficulty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHas difficulty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.112***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.850\u0026ndash;2.410\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.148**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.017\u0026ndash;1.296\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.730***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.498\u0026ndash;1.997\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSleep duration\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;7 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;7 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.197***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.051\u0026ndash;1.363\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDrinking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.346***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.171\u0026ndash;1.547\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.960\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.815\u0026ndash;1.130\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHousehold Economic Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-poor household\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor household\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.892\u0026ndash;1.228\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eBased on CHARLS data, this study examines the incidence and main risk factors of falls among the elderly in China. Our findings reveal an overall fall rate of 18.29% among the elderly, consistent with a previous meta-analysis showing a median rate of 18% [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Compared to the fall rates among the elderly in other countries mentioned earlier, the incidence of falls among Chinese elderly is relatively high, underscoring the need for focused attention on this issue.\u003c/p\u003e \u003cp\u003eAmong demographic variables, we found that the risk of fall is higher among female elderly compared to their male counterparts, which is consistent with previous studies [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This may be due to the gradual decline in estrogen levels with age, making older females more susceptible to osteoporosis [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Additionally, the higher prevalence of arthritis among females [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], as well as the tendency of females to wear inappropriate footwear during certain activities [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], may further increase the risk of fall. Therefore, it is particularly important for female elderly to take preventive measures to avoid falls in daily life. In line with earlier findings [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], the risk of fall increases with age. This could be attributed to age-related physiological decline, including impaired gait stability, deteriorating vision and hearing, and lower limb injuries, all of which reduce the ability to perform daily activities and significantly heighten the risk of fall [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. As aging continues, the elderly become increasingly frail and require greater care and attention.\u003c/p\u003e \u003cp\u003eIn terms of personal health-related variables, consistent with previous research [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e], elderly individuals with poor self-rated health have a higher risk of fall. Self-reported health status is an important indicator of overall health [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] and typically reflects their physical functioning, balance ability, and muscle strength. Conversely, those who rate their health as poor often perceive themselves to be weaker in these areas, which increases their risk of fall. Depression is associated with a higher risk of fall among the elderly, consistent with earlier findings [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. This may be because depressive symptoms can lead to psychomotor impairments, such as slower motor responses and reduced reaction time, which compromise balance and the ability to cope with environmental challenges [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. Developing interventions that target depression may help reduce the risk of fall among the elderly. Elderly individuals with difficulties in ADL face a higher risk of fall, consistent with previous findings [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. This is likely because fall risk is closely associated with ADL capacity [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. Those with ADL difficulties often lack the ability to perform daily tasks independently and tend to have poorer balance and coordination, which may increase their likelihood of fall in daily life. The presence of chronic diseases has also been shown to elevate fall risk among the elderly [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e], which is consistent with our findings. Recurrent symptoms associated with chronic diseases can negatively affect balance function [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. For example, elderly individuals with diabetes or hypertension may experience neuropathy or blood pressure fluctuations, impairing their balance and increasing their risk of fall [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Moreover, elderly individuals experiencing physical pain are more likely to fall, which is consistent with previous research [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Pain is a common and debilitating health stressor that often limits daily activities [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e], which may in turn increase vulnerability to falls.\u003c/p\u003e \u003cp\u003eAs for personal behavior-related factors, consistent with previous research [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], elderly individuals who drink have a higher risk of fall. This may be because alcohol consumption affects physiological functions and significantly impairs postural control, which is detrimental to balance [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. Elderly drinkers are more sensitive to the coordination impairments caused by alcohol [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e], thus increasing their fall risk. Elderly individuals with short sleep duration are at higher risk of fall, consistent with previous findings [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. Sleep is a crucial factor for initiating or maintaining physical activity [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e], and insufficient sleep can lead to poor mental state. Additionally, sleep problems may impair cognitive function and psychomotor performance, with significant associations found between sleep deprivation, slower gait speed, and dynamic instability [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e], which increases fall risk. Regarding other associated variables, elderly individuals dissatisfied with their lives and children face a higher risk of fall. A key factor associated with elderly life satisfaction is family relationships [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. Family serves as the most important bond in social life, providing individuals with a sense of belonging, security, and support. A lack of family support or dysfunctional family dynamics can lower life satisfaction, which often triggers negative emotions [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. Negative emotions can affect the overall well-being of the elderly, increasing their fall risk. Furthermore, in China\u0026rsquo;s traditional family culture centered around filial piety, elderly individuals often exhibit strong emotional dependence on their children and high expectations. If intimate and reciprocal relationships are not established, this can lead to poor mental health and increase the fall risk. Children can improve parental satisfaction through economic [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e] and emotional support [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e], enhancing the psychological well-being of the elderly and reducing fall risk. It is noteworthy that social activities may increase the fall risk among elderly individuals, which contradicts previous studies [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. This could be due to the fact that social activities in our sample mainly involved playing mahjong indoors, and prolonged sitting while playing may increase fatigue. Research has shown that fatigue is also a risk factor for falls [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e], as mental fatigue can impair gait performance, thus increasing the likelihood of falls [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur study indicates that the incidence of falls among elderly people in China is relatively high. As China's population continues to age, the number of elderly individuals experiencing falls may further increase, leading to greater pressure and challenges for families and society. Identifying effective methods to prevent falls in the elderly has become a public health priority. Based on the factors influencing falls in the elderly, we recommend the following measures: increasing awareness of fall prevention, strengthening family support, developing community care services, improving physical and mental health for the elderly, promoting healthy lifestyles, and paying particular attention to female and the older elderly population. By implementing targeted, multi-dimensional strategies and interventions, the aim is to effectively reduce the incidence of falls in the elderly and promote healthy aging.\u003c/p\u003e \u003cp\u003eOur study has several advantages. First, the main strength of this study lies in its use of a nationally representative sample, which provides rich data to support the reliability of our conclusions. Second, we examined a range of risk factors influencing falls among the elderly, which enhanced the comprehensiveness of our findings. Finally, our results not only provide valuable evidence for fall prevention among elderly people in China but also offer useful insights for other countries, particularly for developing nations, in formulating fall prevention and intervention strategies.\u003c/p\u003e \u003cp\u003eHowever, this study has certain limitations. First, due to the use of cross-sectional data, the causal relationship between falls and related factors among the elderly cannot be established. Second, the 2020 CHARLS survey data was collected during the COVID-19 pandemic, and some factors related to falls (such as medication use, vision status, BMI, etc.) were not included in the survey, meaning their impact on falls among the elderly was not assessed. Finally, the information collected from participants was self-reported, which introduces a potential risk of recall bias.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo animal studies are presented in this manuscript. No potentially identifiable human images or data are presented in this study. Ethical approval for all the waves of the China Health and Retirement Longitudinal Study (CHARLS) was granted by the Institutional Review Board at Peking University. The IRB approval number is IRB00001052-11015.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the participants signed written informed consent forms prior to participating in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Postgraduate Scientific Research Innovation Project of Hunan Province (Grant No. CX20240632)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN.Z. contributed to writing the original draft, formal analysis, validation and data curation. D.L. was responsible for conceptualization, writing review and editing, software,\u0026nbsp;methodology,\u0026nbsp;visualization\u0026nbsp;and funding acquisition. All authors have read, approved, and consented to the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors sincerely thank the China Health and Retirement Longitudinal Study team for providing the research dataset.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSchick, S. \u003cem\u003eet al.\u003c/em\u003e Fatal falls in the elderly and the presence of proximal femur fractures. \u003cem\u003eInt. J. Legal Med.\u003c/em\u003e \u003cstrong\u003e132\u003c/strong\u003e, 1699\u0026ndash;1712 (2018). https://doi.org/10.1007/s00414-018-1876-7\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). 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Sci.\u003c/em\u003e \u003cstrong\u003e73\u003c/strong\u003e, 792-797 (2018). https://doi.org/10.1093/gerona/glx210\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Elderly, Falls, Influencing factors, Risk factors, China","lastPublishedDoi":"10.21203/rs.3.rs-6612142/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6612142/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eFalls among the elderly are a significant public health concern. This study aims to explore and analyze the risk factors associated with falls among the elderly in China, in order to develop appropriate interventions to minimize fall risk. By using data from the China Health and Retirement Longitudinal Study, this study analyzes the incidence of falls and employs a logistic regression model to identify the influencing factors. A total of 8,170 samples were included in the analysis. Results show that the overall incidence of falls among the elderly is 18.29%. Being female, older age, poor self-rated health, depression, ADL difficulty, chronic diseases, physical pain, drinking, short sleep duration, dissatisfaction with life, and dissatisfaction with children were all significantly associated with a higher likelihood of falls. With the aging population accelerating, falls among the elderly are becoming increasingly serious, severely affecting their daily functioning and quality of life. Therefore, greater attention should be paid to these risk factors, and timely, targeted prevention and intervention strategies should be implemented to effectively reduce fall incidence.\u003c/p\u003e","manuscriptTitle":"Risk Factors for Falls Among the Elderly in China: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-03 11:00:07","doi":"10.21203/rs.3.rs-6612142/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"38cbb1cb-295c-44f7-b559-db2367ebd108","owner":[],"postedDate":"June 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":49371975,"name":"Health sciences/Risk factors"},{"id":49371976,"name":"Health sciences/Pathogenesis/Oncogenesis"},{"id":49371977,"name":"Health sciences/Medical research/Epidemiology"}],"tags":[],"updatedAt":"2025-10-15T13:09:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-03 11:00:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6612142","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6612142","identity":"rs-6612142","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}