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Association between Recent Falls and Changes in Outdoor Environments near Community-Dwelling Older Adults’ Homes over Time: Findings from the NHATS Study

Author

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  • Sungmin Lee

    (Department of Plant Science and Landscape Architecture, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT 06268, USA)

  • Chanam Lee

    (Department of Landscape Architecture & Urban Planning, College of Architecture, Texas A&M University, College Station, TX 77843, USA)

  • Marcia G. Ory

    (Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, College Station, TX 77843, USA)

Abstract

Neighborhood environments have been increasingly associated with incidents of falling and the fear of falling. However, little is known about the causal impact of neighborhood environments on falling. This study identifies whether changes in outdoor environmental attributes over a one-year period are associated with the occurrence of recent falls among community-dwelling older adults aged 65 and older in the United States. Data were obtained from 4802 adults aged 65 years or older from the National Health and Aging Trends Study (NHATS). Logistic regression analyses were performed to identify neighborhood risk factors linked to the odds of experiencing recent falls at the one-year follow-up. Almost one in ten subjects (9.7% of 4802 subjects) who had not fallen before reported experiencing recent falls after one year. After adjusting for sociodemographic, health, and walking-related behavioral covariates, these subjects were more likely to reside in areas with higher environmental barriers on sidewalks/streets and uneven walking surfaces or broken steps, compared to non-fallers. Our findings suggest that safe and well-maintained outdoor environments may help prevent falls among community-dwelling older adults who engage in outdoor activities. Clinical and environmental interventions for promoting both safe walking and safe environments are warranted.

Suggested Citation

  • Sungmin Lee & Chanam Lee & Marcia G. Ory, 2019. "Association between Recent Falls and Changes in Outdoor Environments near Community-Dwelling Older Adults’ Homes over Time: Findings from the NHATS Study," IJERPH, MDPI, vol. 16(18), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3230-:d:263851
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    References listed on IDEAS

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    1. Sungmin Lee & Chanam Lee & Susan Rodiek, 2017. "Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers," IJERPH, MDPI, vol. 14(2), pages 1-13, February.
    2. Frieden, T.R., 2010. "A framework for public health action: The health impact pyramid," American Journal of Public Health, American Public Health Association, vol. 100(4), pages 590-595.
    3. Li, W. & Keegan, T.H.M. & Sternfeld, B. & Sidney, S. & Quesenberry Jr., C.P. & Kelsey, J.L., 2006. "Outdoor falls among middle-aged and older adults: A neglected public health problem," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1192-1200.
    4. Emily Joy Nicklett & Matthew C. Lohman & Matthew Lee Smith, 2017. "Neighborhood Environment and Falls among Community-Dwelling Older Adults," IJERPH, MDPI, vol. 14(2), pages 1-15, February.
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    Cited by:

    1. Giulia Ogliari & Jesper Ryg & Karen Andersen-Ranberg & Lasse Lybecker Scheel-Hincke & Tahir Masud, 2022. "Perceived neighbourhood environment and falls among community-dwelling adults: cross-sectional and prospective findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)," European Journal of Ageing, Springer, vol. 19(4), pages 1121-1134, December.
    2. Lee, Sungmin & Ye, Xinyue & Nam, Ji Won & Zhang, Kai, 2022. "The association between tree canopy cover over streets and elderly pedestrian falls: A health disparity study in urban areas," Social Science & Medicine, Elsevier, vol. 306(C).
    3. Angela Curl & Helen Fitt & Melanie Tomintz, 2020. "Experiences of the Built Environment, Falls and Fear of Falling Outdoors among Older Adults: An Exploratory Study and Future Directions," IJERPH, MDPI, vol. 17(4), pages 1-15, February.

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