Risk of fall-related emergency department visits following impaired intrinsic capacity among community older adults in Taiwan.

BACKGROUND: Intrinsic capacity (IC) reflects composite physical and mental capacities of aging populations. This study examined associations between IC impairments, severity, and patterns with fall-related emergency department (ED) visits in Taiwan. METHODS: We conducted a population-based cohort study using Taiwan's Integrated Care for Older People (ICOPE) database linked to National Health Insurance claims and Death Registry. A total of 244,899 adults aged ≥65 years were followed from 2022 to 2023. Six IC domains (cognition, mobility, vitality, vision, hearing, and psychological well-being) were assessed. IC severity was categorized as high (0 impairments), moderate (1-2), or low (≥3). Latent class analysis (LCA) identified IC impairment patterns. Poisson regression estimated rate ratios (RRs), adjusting for confounders. RESULTS: Over 213,528 person-years, 1485 fall-related ED visits occurred among 1375 participants (fall-related ED visit rate: 6.95 visits per 1000 person-years). Impairments in cognition (aRR = 1.23, 95% CI: 1.03-1.47), mobility (aRR = 1.58, 95% CI: 1.37-1.82), and vision (aRR = 1.20, 95% CI: 1.07-1.36) were independently associated with increased fall risk. Compared with high IC, low IC was associated with higher risk of fall-related ED visits. LCA identified five IC patterns; the highest risk occurred in the physio-cognitive decline with sensory impairment (aRR = 1.87, 95% CI: 1.60-2.19), followed by all-domain impairments (aRR = 1.81, 95% CI: 1.41-2.67) and nutritional-visual-physical impairments (aRR = 1.53, 95% CI: 1.12-2.09). CONCLUSIONS: IC impairments, severity, and patterns independently predicted fall-related ED visits. Integrating ICOPE screening into primary care may enhance fall prevention strategies.