Shen D, Sun L, Cheng WP, Wang TT, Gu HY. Construction of a prediction model for fall risk in older patients with osteoporosis and comorbid with psychiatric disorders. World J Psychiatry 2026; 16(10): 121714 [DOI: 10.5498/wjp.121714]
Corresponding Author of This Article
Hai-Yan Gu, MD, Chief Physician, Department of Nursing, Affiliated Nantong Clinical College of Nantong University, Nantong First People’s Hospital, No. 666 Shengli Road, Nantong 226001, Jiangsu Province, China. guhaiyan.2009@163.com
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Shen D, Sun L, Cheng WP, Wang TT, Gu HY. Construction of a prediction model for fall risk in older patients with osteoporosis and comorbid with psychiatric disorders. World J Psychiatry 2026; 16(10): 121714 [DOI: 10.5498/wjp.121714]
World J Psychiatry. Oct 19, 2026; 16(10): 121714 Published online Oct 19, 2026. doi: 10.5498/wjp.121714
Construction of a prediction model for fall risk in older patients with osteoporosis and comorbid with psychiatric disorders
Dan Shen, Li Sun, Wei-Ping Cheng, Ting-Ting Wang, Hai-Yan Gu
Dan Shen, Ting-Ting Wang, Department of Spine Surgery, Affiliated Nantong Clinical College of Nantong University, Nantong First People’s Hospital, Nantong 226001, Jiangsu Province, China
Li Sun, Department of Thoracic Surgery, Affiliated Nantong Clinical College of Nantong University, Nantong First People’s Hospital, Nantong 226001, Jiangsu Province, China
Wei-Ping Cheng, Hai-Yan Gu, Department of Nursing, Affiliated Nantong Clinical College of Nantong University, Nantong First People’s Hospital, Nantong 226001, Jiangsu Province, China
Co-first authors: Dan Shen and Li Sun.
Author contributions: Shen D and Sun L contributed equally to this study as they are co-first authors, including the research design, data collection, statistical analysis, and manuscript writing and revision; Gu HY provided overall research guidance and conducted a critical review and final revision of the manuscript; Cheng WP and Wang TT participated in the data organization, literature review, and manuscript proofreading; all authors reviewed and approved the final version of the manuscript.
AI contribution statement: No AI tools were applied during manuscript preparation. All contents were independently finished by authors, who take full responsibility for this work.
Supported by Nantong University Special Research Fund for Clinical Medicine, No. 2025LY056 and No.2023HY002.
Institutional review board statement: This study has been approved for Ethics Committee Nantong Clinical College of Nantong University, Nantong First People’s Hospital (approval No. NT2025012-16).
Informed consent statement: All study participants and their legal guardians provided written informed consent before recruitment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Corresponding author: Hai-Yan Gu, MD, Chief Physician, Department of Nursing, Affiliated Nantong Clinical College of Nantong University, Nantong First People’s Hospital, No. 666 Shengli Road, Nantong 226001, Jiangsu Province, China. guhaiyan.2009@163.com
Received: April 28, 2026 Revised: June 5, 2026 Accepted: June 26, 2026 Published online: October 19, 2026 Processing time: 164 Days and 23.2 Hours
Abstract
BACKGROUND
Older patients with osteoporosis have a high risk of falls, and depression and anxiety can aggravate this risk. At present, there is a lack of an accurate prediction model integrating physical and mental indicators.
AIM
To investigate the effect of comorbid depression/anxiety on fall risk in older patients with osteoporosis and to establish an individualized fall risk prediction model.
METHODS
A total of 130 older patients with osteoporosis admitted between December 2022 and December 2025 were divided into fall (58 cases) and non-fall (72 cases) groups according to whether falls occurred within the past year. Data were collected via questionnaire surveys, medical record reviews, and functional evaluations. Multivariate logistic regression analysis was used to screen for independent influencing factors, and a nomogram prediction model was constructed. Model discrimination and calibration were assessed by receiver operating characteristic curve and Hosmer-Lemeshow test.
RESULTS
The incidence of falls was 44.62%. Univariate and multivariate logistic regression analyses showed that a history of falls [odds ratio (OR) = 4.326, 95% confidence interval (CI): 1.987-9.416], Geriatric Depression Scale score (OR = 1.342, 95%CI: 1.127-1.598), Generalized Anxiety Disorder 7-item score (OR = 1.287, 95%CI: 1.082-1.531), and Timed Up and Go Test duration (OR = 1.218, 95%CI: 1.065-1.393) were independent risk factors for falls (P < 0.05). The Berg Balance Scale score (OR = 0.891, 95%CI: 0.826-0.961) and 25-hydroxyvitamin D levels (OR = 0.912, 95%CI: 0.855-0.973) were independent protective factors (P < 0.05). The prediction model established based on these six indicators had an area under the receiver operating characteristic curve of 0.876 (95%CI: 0.817-0.935), sensitivity of 0.845, and specificity of 0.819. The Hosmer-Lemeshow goodness-of-fit test showed χ2 = 7.864, P = 0.447.
CONCLUSION
Comorbid depression/anxiety is an independent risk factor for falls in older patients with osteoporosis. The model integrating psychological and physical function assessment shows favorable predictive performance for identifying high-risk patients and guiding intervention strategies.
Core Tip: Older patients with osteoporosis are prone to falls, and this study identified depression, anxiety, poor balance, and low vitamin D levels as key contributing factors. Early screening of high-risk individuals was enabled by a predictive model that combined psychological and physical indicators and showed good performance.
