Relationship between malnutrition and different fall risk assessment tools in a geriatric in-patient unit



Despite decades of research evaluating different predictive strategies to identify persons at risk for falls, nutritional issues have received little attention. Malnutrition leads to weight loss associated with muscle weakness and consequently increases the risk of falls.


The current study assessed the association between nutritional state and fall risk scores in a geriatric in-patient unit in Ain Shams University Hospital, Cairo, Egypt.


A cross-sectional study was conducted to assess the nutritional state of 190 older inpatients using a short form of the Mini-Nutritional Assessment (MNA-SF), and the risk of falls was assessed using the Morse Fall Scale (MFS), Johns Hopkins fall risk assessment tool (JH-FRAT), Schmid Fall Risk Assessment Tool (Schmid-FRAT), Hendrich II Fall Risk Model (HII-FRM) and Functional Assessment Instrument (FAI). The generalised linear models (GLM) and odds ratio (OR) were calculated to test the nutritional status as a risk factor for falls.


Malnutrition was significantly associated with high fall risk as assessed by MFS and HII-FRM (OR = 2.833, 95% CI 1.358–5.913, P = 0.006; OR = 3.477, 95% CI 1.822–6.636, P < 0.001), with the highest OR for JH-FRAT (OR = 5.455, 95% CI 1.548–19.214, P = 0.008). After adjusting for age, the adjusted Charlson Comorbidity Index (ACCI), number of fall risk-increasing drugs (FRIDs), risk of malnutrition or malnourished were significantly associated with high fall risk as assessed by MFS (OR = 2.761, 95% CI 1.306–5.836, P = 0.008), JH-FRAT (OR = 4.938, 95% CI 1.368–17.828, P = 0.015), and HII-FRM (OR = 3.486, 95% CI 1.783–6.815, P < 0.001).


This study demonstrated a significant association between malnutrition and fall risk assessment scores, especially JH-FRAT, in hospitalised older patients.

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Correspondence to Rania Mohammed Abou-Hashem.

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Statement of human and animal rights: ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Local Ethics Committee of Faculty of Medicine, Ain Shams University.

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Informed oral consent was obtained from all patients included in the study and/or their next of kin, as most of them were illiterate and were accompanied by a nurse prior to enrolment.

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Adly, N.N., Abd-El-Gawad, W.M. & Abou-Hashem, R.M. Relationship between malnutrition and different fall risk assessment tools in a geriatric in-patient unit. Aging Clin Exp Res 32, 1279–1287 (2020).

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  • Malnutrition
  • Nutritional state
  • Fall risk assessment tools
  • Hospitalised older patients