Malnutrition Risk, Rurality, and Falls Among Community-Dwelling Older Adults



We aimed to evaluate if malnutrition and rurality are associated with fall risk and future falls in community-dwelling older adults.


Prospective Cohort.


Community, Vermont.


Older adults receiving home support services who completed a health risk assessment (n=3,300; Mean age 79.6 years ±8.4, 75% female). Additional analysis was completed with a subset of 2,043 participants with two-years of consecutive health assessments.


Fall Risk Questionnaire, DETERMINE Nutrition Risk Questionnaire, and fall history.


Independently, high malnutrition risk and rurality were associated with fall risk (p<0.001) and high malnutrition risk was associated with rurality (p<0.001). After adjusting for age, sex, and physical function, individuals with high nutrition risk had a 66% increase in the odds of falling over the next year, but rurality was not significantly associated with a new fall.


These findings suggest that falls are associated with malnutrition risk, but the relationship between falls and rurality is less evident. Further research is needed to identify services that may best alleviate malnutrition risk in older adults and aspects of nutrition that are most protective against fall risk.

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Funding: Research reported in this publication was supported by an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under grant number P20GM103449. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIGMS or NIH.

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Corresponding author

Correspondence to Nancy M. Gell.

Ethics declarations

Ethics Declarations: This study was considered “non-human subjects” research by the University of Vermont Internal Review Board. Informed consent was deemed as not applicable for secondary analysis of the de-identified dataset.

Conflicts of interest: The authors have no potential conflicts of interest to declare with respect to the research, authorship, or publication of this article. No copyrighted materials were used in the conduct of this study or the preparation of this article.

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Eckert, C., Gell, N.M., Wingood, M. et al. Malnutrition Risk, Rurality, and Falls Among Community-Dwelling Older Adults. J Nutr Health Aging (2021).

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Key words

  • Fall risk
  • nutrition
  • rural health
  • screening
  • older adult