Risk Profiles for Falls among Older Adults: New Directions for Prevention

Satariano, William A.; Wang, Constance; Kealey, Melissa; Kurtovich, Elaine; Phelan, Elizabeth A.

doi:10.3389/fpubh.2017.00142

Cited by 12 publications

(10 citation statements)

References 41 publications

(43 reference statements)

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“…In our study, more than two-thirds of frail study participants fell indoors, while pre-frail participants mostly fell outdoors. This is consistent with previous studies showing that relatively healthy and active older adults fall more often outdoors whereas frail older adults are more likely to fall indoors [37][38][39]. These differences may be best explained by differences in health status and level of physical activity between pre-frail and frail adults.…”

Section: Discussionsupporting

confidence: 92%

Influence of fall environment and fall direction on risk of injury among pre-frail and frail adults

et al. 2019

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In this prospective study, half of all falls resulted in injury. Pre-frail adults sustained more injuries, while more frail adults had injuries requiring hospitalization or fractures. Pre-frail adults fell more often when in movement compared with frail adults who fell more often when standing and in indoor public spaces. Purpose To assess prospectively how fall environment and direction are related to injury among pre-frail and frail adults. Methods We included 200 community-dwelling adults with a prior fall (pre-frail, mean age 77 years) and 173 adults with acute hip fracture (frail, mean age 84 years; 77% community-dwelling). Falls were prospectively recorded using standardized protocols in monthly intervals, including date, time, fall direction and environment, and injury. We used logistic regression to assess the odds of injury adjusting for age, body mass index (BMI), and gender. Results We recorded 513 falls and 331 fall-related injuries (64.5%) among the 373 participants. While the fall rate was similar between groups, pre-frail adults had more injuries (71% among pre-frail vs. 56% among frail, p = 0.0004) but a lower incidence of major injuries (9% among pre-frail vs. 27% among frail, p = 0.003). Pre-frail adults fell more often while in movement (84% among pre-frail vs. 55% among frail, p < 0.0001), and frail adults fell more often while standing (26% vs. 15% respectively, p = 0.01). The odds of injury among frail adults was increased 3.3-fold when falling sideways (OR = 3.29, 95% CI = 1.68-6.45) and 2.4-fold when falling in an indoor public space (OR = 2.35, 95% CI = 1.00-5.53), and was reduced when falling at home (OR = 0.55, 95% CI = 0.31-0.98). The odds of injury among pre-frail adults was not influenced by environment and was 53% lower when falling backwards (OR = 0.47, 95% CI = 0.26-0.82). Conclusion While pre-frail adults sustain more fall-related injuries, frail adults were more likely to sustain major injuries, especially when falling sideways or outside their home.

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Section: Discussionsupporting

confidence: 92%

Influence of fall environment and fall direction on risk of injury among pre-frail and frail adults

et al. 2019

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“…In a longitudinal study of falls occurrence, Lee et al [9] show that older people living in areas with more environmental barriers and worsening environmental conditions were more likely to report a fall at follow up. Greater neighbourhood walkability has been associated with higher prevalence of outdoor falls [18], although this is likely to be due to higher rates of walking, and therefore greater exposure to risk, drawing attention to the complexity of relationships between the urban environment, fear of falling and outdoor falls.…”

Section: Introductionmentioning

confidence: 99%

Experiences of the Built Environment, Falls and Fear of Falling Outdoors among Older Adults: An Exploratory Study and Future Directions

Curl

Fitt

Tomintz

2020

IJERPH

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Falls can have serious impacts on the health, wellbeing and daily mobilities of older adults. Falls are a leading cause of injury and death amongst older adults and outdoor falls comprise a substantial proportion of pedestrian injuries. As well as physical injuries, the psychological impacts of experiencing a fall can result in older adults getting out of the house less often, resulting in lower levels of physical activity and social connection. Despite the known consequences of falls, relatively little research considers the impact of the urban built environment on falls among older adults. This research aimed to explore the experiences of older adults in the urban environment, falling and the fear of falling outdoors. We conducted an online survey with adults aged 50+ using a participatory mapping survey tool and a convenience sample. The study area was Greater Christchurch, New Zealand. Results suggest that both perceived accessibility and neighbourhood conditions are independently associated with fear of falling, after controlling for frequency of falling, gender and activities of daily living. Our findings demonstrate the need for much better understandings of the relationships between the urban environment, outdoor mobility, fear of falling and falling among older adults and we propose suggestions for future research.

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“…Li et al (2014) found older adults living in socioeconomically disadvantaged neighborhoods were more likely to walk for utilitarian versus recreational purposes and experienced a higher rate of falling on sidewalks, streets, and curbs after accounting for other risk factors. Satariano et al (2017) identified a fall-risk typology that suggested frail older adults may limit outdoor activities and be more susceptible to indoor falls due to poor neighborhood safety and walkability. Our findings extend this line of inquiry by examining associations between socioeconomic status and racial status with falls in a national sample, which is important given the regional diversity of sociopolitical climates in the United States that differentially affect health (Baicker et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Home and Neighborhood Context of Falls Among Black and White Older Americans

et al. 2021

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Objectives: To examine social and physical environmental fall-risk factors in a nationally representative sample of community-living older adults overall and by racial group. Methods: We used data from the 2015 and 2016 rounds of the National Health and Aging Trends Study ( n = 5581) linked to census tract measures from the American Community Survey. Recurrent falls are defined as 2+ self-reported falls over 12 months. Results: Older adults with recurrent falls were more likely to have lower education, lower income, financial hardship, live in homes with disorder and disrepair and in neighborhoods without sidewalks, with high social deprivation, and in nonmetropolitan counties. Home disrepair, lack of sidewalks, and residence in a nonmetropolitan county were important fall-risk factors among White older adults only. Financial hardship was an important risk factor among Black older adults. Discussion: Environmental factors are associated with recurrent falls among older Americans and should be incorporated into fall-risk profiles and prevention efforts.

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Risk Profiles for Falls among Older Adults: New Directions for Prevention

Cited by 12 publications

References 41 publications

Influence of fall environment and fall direction on risk of injury among pre-frail and frail adults

Influence of fall environment and fall direction on risk of injury among pre-frail and frail adults

Experiences of the Built Environment, Falls and Fear of Falling Outdoors among Older Adults: An Exploratory Study and Future Directions

Home and Neighborhood Context of Falls Among Black and White Older Americans

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