Abstract Body: Background: Falls are common among older adults and predict subsequent morbidity and mortality. There is a dearth of knowledge about the timing and location of falls in community-based populations of older adults.

Methods: We identified members of Kaiser Permanente Southern California aged ≥65 years diagnosed with hypertension enrolled in the AMBulatoRy blOod preSsure In older Adults (AMBROSIA) study. Demographic and clinical characteristics were obtained from electronic health records while self-administered surveys captured social history and presence of functional impairment. Participants submitted 12 monthly falls calendars recording the time and location of each fall, and whether the fall resulted in medical care. Fisher’s exact test was used to compare participant characteristics between those who reported a fall vs. no fall.

Results: We included 632 participants (mean age 74.6 years [range 65-95]; 57% female; 44% non-Hispanic White, 23% non-Hispanic Black, 18% Hispanic, and 13% Asian/Pacific Islander). Overall, 240 participants (38%) reported 680 falls during follow-up with 9% of falls requiring medical care. Those who reported a fall were older, more likely to be White, have a history of self-reported falls, have consumed alcoholic beverages in the past year and have ≥1 functional impairment (all p-values <.05) compared to those who reported no falls. Over a 24-hour period, 41%, 35%, and 24% of the falls occurred between 6am-12pm, 12pm-6pm, and 6pm-6am, respectively. Further, 59% of falls occurred at an indoor location.

Conclusion: Falls among community-dwelling, older adults with hypertension were common with few requiring medical care. Although most falls occurred during daytime hours, approximately one fourth occurred during nighttime hours. Further, the majority of falls occurred at an indoor location. Providers should be informed that many falls occur among older adults without presentation to a healthcare facility, and strategies should include prevention of falls indoors and during the daytime.