Falls in community-dwelling older adults with heart failure: A retrospective cohort study

•Community-dwelling older Americans with heart failure have a higher fall risk.•Unique relationships exist between functional impairments of heart failure and fall risk.•Large muscle function difficulty is most strongly correlated with fall risk. While heart failure (HF) in older adults is associated with fall risk, little is known about this in the U.S. To examine the independent effect of functional impairments related to HF on falls among community-dwelling older adults in the U.S. A retrospective cohort study was conducted with 17,712 community-dwelling older adults aged 65 and above with (n = 1693) and without HF, using mixed-effects logistic regression to examine the association between HF and falls. HF patients had 14% greater odds of falling than those without HF. Moreover, HF patients with functional difficulties in mobility, large muscle difficulty, instrumental activities of daily living difficulty, poor vision, and urinary incontinence demonstrated an increased likelihood of falling. Community-dwelling older adults with HF and functional difficulties have a higher fall risk than those without HF, indicating that fall prevention programs should be developed, tested, and implemented for this population.