What Doesn't Kill You Doesn't Make You Stronger: The Long-Term Consequences of Nonfatal Injury for Older Adults

Purpose: The majority of research efforts centering on injury among older adults focus on fall-related injuries and shortterm consequences of injury. Little is known about the long-term consequences of all-cause nonfatal injuries, including minor injuries. Using a recent, large, and nationally representative sample of the U.S. non-institutionalized civilian population, the current study examines whether older adults who sustained a nonfatal injury (serious and minor) have higher risk of long-term morbidity and mortality outcomes compared with noninjured seniors. Methods: Linked National Health Interview Survey-Medical Expenditure Panel Survey (NHIS-MEPS) data were used to ft logistic and 2-part models to estimate associations between injury incidence and later injury, hospitalization incidence, and length of hospital stay during the 2.5 years following the NHIS interview among 16,109 older adults. Data from the linked National Health Interview Survey-National Death Index (NHIS-NDI) fles were used to estimate a Cox proportional hazards model to examine the association between injury incidence and mortality for up to 11 years after the initial interview among 79,504 older adults. Results: Relative to no injury, serious nonfatal injury was signifcantly associated with increased risk of another injury, hospitalization, and mortality. Minor injuries were signifcantly related to higher risk of later injury and mortality. Implications: Because even minor injuries are strongly associated with increased risks of later injury and mortality, preventing injury among seniors may be an effective way to improve quality of life and reduce declines in functional capacity. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.