Household environmental hazards and indoor falls in older adults: identifying a modifiable target for prevention.
1
Department of Geriatrics, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, P.R. China, Beijing, China
2
The Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, P.R. China, Beijing, China
3
Beijing Jingcai Intelligent Technology Co., Ltd., Beijing, China
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Falls are a leading cause of injury and loss of independence among older adults. As important indicators of falls, household environmental hazards are modifiable in the short term, but their independent contribution to indoor falls remains incompletely quantified.
METHODS:
We conducted a cross-sectional study across 11 geriatric outpatient clinics in nine provinces of mainland China. We evaluated falls, fear of falling, physical function (Short Physical Performance Battery, SPPB), nutritional status (Mini Nutritional Assessment-Short Form, MNA-SF), and household environmental hazards. 37 household environmental hazards in 9 domains (floor, lighting, stairways/steps, bathroom, kitchen, living room, bedroom, balcony, shoes/walking aids) were assessed using a questionnaire.
RESULTS:
In 328 older patients (73.7±8.8 years, 49.4% female, 9.8% living alone), 284 (86.6%) did not fall, while 44 (13.4%) experienced one or more indoor falls in the past 6 months. Compared with non-fallers, indoor fallers were significantly more concerned about falls (fear of falling: 90.5% vs 55.3%, p<0.001), had worse physical function (SPPB score, median [IQR]: 7.5 [3, 9.25] vs 9 [6,11], p=0.001), and had more household environmental hazards (median [IQR]: 5 [3,7] vs 4 [2,5], p=0.004). Among 9 domains of household hazards, floor (63.6% vs 25.0%) and balcony (9.1% vs 1.4%) hazards were statistically more prevalent in indoor fallers (both p<0.01). In the multi-variable logistic regression model that adjusted for age, gender, living arrangement, and SPPB score, fear of falling (OR [95%CI]: 5.20 [1.72-15.76], p=0.004) and household environmental hazards (OR [95%CI]: 1.15 [1.03-1.28], p=0.014) were independently associated with indoor falls.
CONCLUSIONS:
Household environmental hazards and fear of falling are associated with falls, independent of physical function and age. Public health strategies to prevent falls should combine dynamic household hazards modification with interventions addressing falls-related psychological burdens.
Falls are a leading cause of injury and loss of independence among older adults. As important indicators of falls, household environmental hazards are modifiable in the short term, but their independent contribution to indoor falls remains incompletely quantified.
METHODS:
We conducted a cross-sectional study across 11 geriatric outpatient clinics in nine provinces of mainland China. We evaluated falls, fear of falling, physical function (Short Physical Performance Battery, SPPB), nutritional status (Mini Nutritional Assessment-Short Form, MNA-SF), and household environmental hazards. 37 household environmental hazards in 9 domains (floor, lighting, stairways/steps, bathroom, kitchen, living room, bedroom, balcony, shoes/walking aids) were assessed using a questionnaire.
RESULTS:
In 328 older patients (73.7±8.8 years, 49.4% female, 9.8% living alone), 284 (86.6%) did not fall, while 44 (13.4%) experienced one or more indoor falls in the past 6 months. Compared with non-fallers, indoor fallers were significantly more concerned about falls (fear of falling: 90.5% vs 55.3%, p<0.001), had worse physical function (SPPB score, median [IQR]: 7.5 [3, 9.25] vs 9 [6,11], p=0.001), and had more household environmental hazards (median [IQR]: 5 [3,7] vs 4 [2,5], p=0.004). Among 9 domains of household hazards, floor (63.6% vs 25.0%) and balcony (9.1% vs 1.4%) hazards were statistically more prevalent in indoor fallers (both p<0.01). In the multi-variable logistic regression model that adjusted for age, gender, living arrangement, and SPPB score, fear of falling (OR [95%CI]: 5.20 [1.72-15.76], p=0.004) and household environmental hazards (OR [95%CI]: 1.15 [1.03-1.28], p=0.014) were independently associated with indoor falls.
CONCLUSIONS:
Household environmental hazards and fear of falling are associated with falls, independent of physical function and age. Public health strategies to prevent falls should combine dynamic household hazards modification with interventions addressing falls-related psychological burdens.
| eISSN: | 2654-1459 |
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