Code from: Falls and fall-related injuries and hospitalizations in autistic older adults: A medicare data study
Data files
Jul 14, 2026 version files 327.98 KB
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1._Data_Cleaning_Part_1.sas
38.34 KB
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2._Data_Cleaning_Part_2.sas
32.85 KB
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3._Falls_and_Fall_Injuries.sas
112.05 KB
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4._Depression_and_Insomnia.sas
12.51 KB
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5._Frailty_Score.sas
22.37 KB
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6._Fall-related_hospitalizations.sas
5.80 KB
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7._Table_1_-_Matched.sas
4.47 KB
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7._Table_1_-_Unmatched.sas
4.03 KB
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8._Multivariable_Analysis.sas
19.86 KB
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9._Adjusted_Prevalences.sas
7.07 KB
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Data_Dictionary.docx
22.81 KB
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Data_Dictionary.pdf
35.18 KB
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Proc_Table_1_Macro.sas
4.96 KB
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README.md
5.68 KB
Abstract
Fall-related injuries are a major public health issue for older adults, contributing to mortality, morbidity, decreased functional ability, loss of independence, and increased healthcare costs. Autistic older adults may be at greater risk for falls due to motor coordination difficulties and antipsychotic medication use. This cohort study used multivariable logistic regression to compare the odds of falling and negative binomial regression to compare the rate of fall-related injuries. Data from Medicare Standard Analytical Files (2013-2021) for autistic and non-autistic older adults aged 65+ were analyzed. The sample included 13,732 autistic and 25,497 matched non-autistic older adults. Our dependent variables were (1) falls, (2) unique fall-related injuries, and (3) fall-related hospitalizations. Overall, 47.4 % of autistic older adults had a fall compared to 31.5 % of non-autistic older adults. Autistic older adults also had more fall-related injuries and hospitalizations. Accounting for duration of observation, autistic older adults had significantly higher odds of any fall (odds ratio = 1.99; 95 % confidence interval = 1.89-2.08), rate of fall-related injuries (incidence rate ratio = 1.93; 95 % confidence interval = 1.86-2.01), and rate of fall-related hospitalizations (incidence rate ratio = 1.43; 95 % confidence interval = 1.35-1.51) than non-autistic older adults. These findings highlight the need for targeted fall prevention strategies for autistic older adults to reduce morbidity and mortality.
Dataset DOI: 10.5061/dryad.stqjq2cjm
Description of the data and file structure
PROJECT OVERVIEW
This project uses Medicare claims data (Parts A & B) to compare the odds and rates of falls, fall-related injuries, and fall-related hospitalizations between autistic vs. non-autistic older adults after controlling for dementia risk factors.
Key components:
- Data Cleaning and Variable Generation: Prepares raw Medicare claims data for analysis
- Table Generation: Produces descriptive and outcome tables for matched and unmatched cohorts.
- Matched Cohort Analysis: Uses propensity-score matching (1 autistic : ~2 non-autistic ratio) to perform multivariable analysis and estimate adjusted prevalences
NOTE: This project uses restricted Medicare data that require CMS Data Use Agreement (DUA) approval. The datasets cannot be shared publicly.
TOOLS AND DEPENDENCIES
- Language: SAS v9.4
- Required Access: Secure server with Medicare Parts A & B claims files
- Matching Method: Variable-ratio propensity score matching
- Required SAS Macros: Ensure "Proc Table 1 Macro.sas" is saved in the working directory before running table generation scripts.
PROJECT STRUCTURE
project_root
├── data_cleaning
│ ├── 1. Data Cleaning Part 1.sas
│ ├── 2. Data Cleaning Part 2.sas
│ ├── 3. Falls and Fall Injuries.sas
│ ├── 4. Depression and Insomnia.sas
│ ├── 5. Frailty Score.sas
│ ├── 6. Fall-related hospitalizations.sas
├── table_generation
│ ├── Proc Table 1 Macro.sas
│ ├── 7. Table 1 - Unmatched.sas
│ ├── 7. Table 1 - Matched.sas
├── analysis
│ ├── 8. Multivariable Analysis.sas
│ ├── 9. Adjusted Prevalences.sas
├── docs
│ ├── Data Dictionary.docx
│ ├── Data Dictionary.pdf
│ ├── README.md
FILE DESCRIPTIONS
- 1. Data Cleaning Part 1.sas: Cleans and prepares raw Medicare data
- 2. Data Cleaning Part 2.sas: Finalizes analytic cohort and matching
- 3. Falls and Fall Injuries.sas: Creates falls and fall-related injuries outcomes
- 4. Depression and Insomnia.sas: Creates baseline depression and insomnia indicators
- 5. Frailty Score.sas: Creates frailty score
- 6. Fall-related hospitalizations.sas: Identifies fall-related hospitalizations
- Proc Table 1 Macro.sas: Macro to produce descriptive statistics
- 7. Table 1 - Unmatched.sas: Generates descriptive statistics for unmatched cohort
- 7. Table 1 - Matched.sas: Generates descriptive statistics for matched cohort
- 8. Multivariable Analysis.sas: Uses logistic and negative binomial models to produce results
- 9. Adjusted Prevalences.sas: Uses log-binomial models to produce adjusted prevalences
- Data Dictionary.docx: Variable names and definitions
- Data Dictionary.pdf: Same as "Data Dictionary.docx," but as as pdf
- README.md: Project overview and instructions
HOW TO RUN
/* Step 1: Data Cleaning */
- Run the file "1. Data Cleaning Part 1.sas"
- Run the file "2. Data Cleaning Part 2.sas"
- Run the file "3. Falls and Fall Injuries.sas"
- Run the file "4. Depression and Insomnia.sas"
- Run the file "5. Frailty Score.sas"
- Run the file "6. Fall-related hospitalizations.sas"
/* Step 2: Table Generation */
- Run the file "7. Table 1 - Unmatched.sas"
- Run the file "7. Table 1 - Matched.sas"
/* Step 3: Analysis */
- Run the file "8. Multivariable Analysis.sas"
- Run the file "9. Adjusted Prevalences.sas"
DATA USE DISCLAIMER
Medicare data are protected under CMS Data Use Agreements. This repository does NOT include raw data. Users must obtain appropriate DUA approval to access Medicare claims.
CITATION
If you use this project or scripts, please cite:
Bishop, L., Blake, M., Nikahd, M., Hyer, J. M., Patterson, B. W., Wolf, B. J., & Hand, B. N. (2026). Falls and Fall-Related Injuries and Hospitalizations in Autistic Older Adults: A Medicare Data Study. Autism : the international journal of research and practice, 30(6), 1443–1451. https://doi.org/10.1177/13623613261433988. PMID: 42037214
Files and variables
File: 1._Data_Cleaning_Part_1.sas
Description: Cleans and prepares raw Medicare data
File: 2._Data_Cleaning_Part_2.sas
Description: Finalizes analytic cohort and matching
File: 3._Falls_and_Fall_Injuries.sas
Description: Creates falls and fall-related injuries outcomes
File: 4._Depression_and_Insomnia.sas
Description: Creates baseline depression and insomnia indicators
File: 5._Frailty_Score.sas
Description: Creates frailty score
File: 6._Fall-related_hospitalizations.sas
Description: Identifies fall-related hospitalizations
File: 7._Table_1_-_Matched.sas
Description: Generates descriptive statistics for matched cohort
File: 7._Table_1_-_Unmatched.sas
Description: Generates descriptive statistics for unmatched cohort
File: 8._Multivariable_Analysis.sas
Description: Uses logistic and negative binomial models to produce results
File: 9._Adjusted_Prevalences.sas
Description: Uses log-binomial models to produce adjusted prevalence
File: Proc_Table_1_Macro.sas
Description: Macro to produce descriptive statistics
File: Data_Dictionary.docx
Description: Variable names and definitions
File: Data_Dictionary.pdf
Description: Variable names and definitions