Abstract
Falls are one of the common problems among older adults; it is estimated that 684,000 fatal cases of falls occur every year. Furthermore, falls constitute one of the leading causes of mortality due to accidental injury. This study aims to identify the risk factors for falls in the older adults who live in the community, according to the dimensions of the living area: in urban and rural. The proportional sampling method was used to identify the rural and urban areas in West Java Prefecture; meanwhile, the incidence of fall in the last 12 months was selected as the outcome variable. Furthermore, sociodemographic background, chronic medical condition, fear of falling, visual and hearing impairments, Activity of Daily Living (ADL), Barthel index, physical performance (Short Performance Physical Battery (SPPB)), and living environment were analyzed to identify the risk factors that contribute to the incidence of falls. A total of 611 older adults participated in this study: 62% of them are living in rural area and 38% of them are living urban areas. More than 70% of study participants were aged 60–69 years, while 73% were females. There is no significant difference in fall prevalence in rural (16.5%) and urban (10.7%) areas (p value = 0.228). Furthermore, the multiple logistic regression analysis showed that the male gender (OR = 0.29, 95%CI [0.09–0.88]), chronic illness (OR = 3.25, 95%CI [1.24–8.53]), and visual impairment (OR = 3.6, 95%CI [1.52–8.54]) were associated with fall among older adults in urban areas. Meanwhile, visual impairment (OR = 1.81, 95%CI [1.03–3.18]) and living environment (OR = 3.36, 95% CI [1.14–9.93]) were significantly associated with falls in rural areas. Based on the associated risk factors identified in this study, a different approach is needed to reduce the falling risk among older adults in urban and rural areas in Indonesia.
Highlights
Falls are one of the common problems among older adults; it is estimated that 684,000 fatal cases of falls occur every year
Falls constitute one of the leading causes of mortality due to accidental injury. is study aims to identify the risk factors for falls in the older adults who live in the community, according to the dimensions of the living area: in urban and rural
Given the longstanding disparities in rural and urban areas, this study aims to investigate the rural-urban dimension of falls among the Indonesian older adult population. e differences between both environments determine the types of fall risk faced by adults. ese include population density, percentage of agricultural households, and the presence or access to urban facilities such as roads, formal education, and public health facilities, etc. [34]. e Indonesian older adult population is widely distributed with a higher population (52.8%) in the urban compared to rural areas (47.20%) [8]
Summary
Falls are one of the common problems among older adults; it is estimated that 684,000 fatal cases of falls occur every year. Is condition affects balance and increases falling risk; fall-related injury has been identified as a major public health issue. At 10%, the country is expected to have an aging population structure Given such a large population, there is a need to explore the risk factors associated with accidental falls and deterioration of health. The various consequences of falls in older adults include post-fall anxiety syndrome, injury to either soft tissue or broken bones, hospital treatment, disability (decreased mobility), decreased functional status or dependency, increased use of health care facilities, and death [9,10,11,12]. Fall-related risk among community-dwelling older adults differs from assessment in a hospital or long-term care facility setting. Multiple factors have been shown to increase fall risk in community-dwelling adults aged 65 years and above
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