MGMIMass Gathering Medicine

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Risk factors and locations of falls among older pilgrims during Hajj: Implications for targeted prevention[1]

Alkeridy WA, Alharbi KK, Sofi SM, et al; Almarwani MM · 2025 · J Infect Public Health

Summary

Cross-sectional survey of 777 pilgrims aged >=60 (median 68) at the 2024 Hajj: 5.0% reported falls, concentrated at the highest-density sites — Mena 46.2%, Grand Mosque and Arafat 17.9% each — and during specific activities (Jamarat throwing, bathrooms, stairs). Independent predictors: non-Saudi nationality (OR 2.53) and asthma (OR 3.78). 28.2% of fallers were injured; 23.1% needed emergency care. Recommends pre-travel assessment, multilingual education, infrastructure improvement, designated walking paths, and exploration of real-time fall surveillance.

So what

The geriatric-syndromes face of mass-gathering medicine, mapped to place: falls at Hajj cluster where density peaks and at mundane choke points (bathrooms, stairs) rather than exotic hazards — meaning prevention is infrastructure and wayfinding, not medicine. With half of Hajj heat casualties aged >=60 (Elfaki) and this fall burden in the same cohort, the elderly-pilgrim risk core is now documented across two mechanisms; MGMI's pilgrimage pages should carry a geriatric section citing both. The non-Saudi predictor repeats the visitor-vulnerability theme from Simon (Atlanta pediatrics) at the other end of life.

Key findings

  • 777 pilgrims >=60 at Hajj 2024: 5.0% fell; 28.2% of fallers injured, 23.1% needed emergency care
  • Falls concentrate at Mena (46.2%), Grand Mosque, Arafat - density-linked
  • Activity hotspots mundane: Jamarat throwing, bathrooms, stairs
  • Predictors: non-Saudi nationality OR 2.53, asthma OR 3.78
  • Prevention = infrastructure, wayfinding, pre-travel assessment, multilingual education

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