Outdoor hazards and falls among community-dwelling older Australians

Abstract

Background: Falls occur in approximately one-third of older Australians per year and can be attributed to intrinsic or extrinsic factors, but are often reported by the elderly to be associated with the latter: environmental hazards. The objective of this study was to investigate outdoor falls and their relationship with outdoor hazards among community-dwelling older people in the City of Sydney. Methods: Focus group discussions (n=47) and structured interviews (n=124) were conducted among Sydney residents aged 60 years and older to explore issues regarding their residential environments and health outcomes. Structured interviews addressed experiences of indoor and outdoor falls and near falls, and participants’ perception of hazards in their outdoor environment. Results: The focus groups suggested that outdoor falls are common and are associated with insufficient street lighting, uneven road/path surfaces, tree roots, and fallen seed pods from Plane trees. In the survey, 35.5% of participants reported an outdoor fall or near fall. Poisson regression analysis, while accounting for other potential predictors, demonstrated that the risk of an outdoor fall or near fall was higher for footpaths of lower perceived quality and a non-Asian ethnic background. Conclusions: Outdoor falls are a substantial problem among community-dwelling older Australians and outdoor hazards may contribute to these falls. Future fall prevention interventions should evaluate whether modification of the outdoor environment reduces outdoor falls.