Abstract
BackgroundHazardous environmental exposures are recognized risk factors for falls among older adults. However, the gender differences in the associations of falls with indoor and outdoor environmental hazards are scarce. This study examined the indoor and outdoor environmental risk factors for falls and compared the data for men and women among U.S. older adults using nationally representative data.MethodsWe used the 2011 National Health and Aging Trends Study (NHATS) for a cross-sectional analysis of 6680 community-dwelling adults aged ≥65 years in the United States. A series of logistic regressions was used to identify the indoor and outdoor environmental hazards associated with falls stratified by gender after adjusting for sociodemographic, health, and behaviors. We also tested for significant interactions with gender.ResultsCompared to men, women had a higher prevalence of falls. In the model adjusted for sociodemographic, health, and behavioral conditions, there were gender differences in the association of falls with the presence of indoor and outdoor environmental hazards. Gender-specific analyses showed that women with the presence of indoor environmental hazards (OR = 1.37, 95% CI = 1.04.-1.79) had higher odds of falls, whereas for men, the presence of outdoor environmental hazards (OR = 1.34, 95% CI = 1.02–1.75) was associated with falls. We also found a significant interaction term between outdoor environmental hazards and gender (OR = 0.65, 95% CI = 0.47–0.90). The interaction plot indicated that the presence of outdoor environmental hazards increased the risks of falling in men but not in women.ConclusionsSignificant gender differences exist in the association of falls with indoor and outdoor environmental hazards among older men and women. Our findings suggest that gender-tailored prevention programs to increase awareness of the environmental hazards and gender-specific environmental interventions are needed to help prevent falls.
Highlights
Falls among older adults have received considerable attention as a major public health concern in the United States
Study design, setting, and sample The present study investigated data from the National Health and Aging Trends Study (NHATS), which is an ongoing longitudinal study that surveys a nationally representative sample of 35.3 million Medicare beneficiaries aged 65 or older who reside in the United States [33]
29.6% of the participants reported any fall within a year
Summary
One-fourth of communitydwelling adults aged 65 years or older in the United States experience falls each year [1]. Among those who fall, one-third suffer serious injury, including hip fractures and traumatic brain injury that may require hospitalization [2]. Environmental factors refer to all attributes that are external to the human host, which include slippery or uneven surface, obstacles, stairs, abrupt vertical transitions, and weather condition [7]. These individual and environmental factors are known to be independently associated with the occurrence of falls [8]. This study examined the indoor and outdoor environmental risk factors for falls and compared the data for men and women among U.S older adults using nationally representative data
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