Satariano William A, Wang Constance, Kealey Melissa E, Kurtovich Elaine, Phelan Elizabeth A
School of Public Health, University of California Berkeley, Berkeley, CA, United States.
Department of Medicine, Division of Gerontology and Geriatric Medicine, School of Public Health, University of Washington, Seattle, WA, United States.
Front Public Health. 2017 Aug 2;5:142. doi: 10.3389/fpubh.2017.00142. eCollection 2017.
To address whether neighborhood factors, together with older adults' levels of health and functioning, suggest new combinations of risk factors for falls and new directions for prevention. To explore the utility of Grade-of-Membership (GoM) analysis to conduct this descriptive analysis.
This is a cross-sectional, descriptive study of 884 people aged ≥65 years from Alameda County, CA, Cook County, IL, Allegheny County, PA, and Wake and Durham counties, NC. Interviews focused on neighborhood characteristics, physical and cognitive function, walking, and falls and injuries. Four risk profiles (higher order interactions of individual and neighborhood factors) were derived from GoM analysis.
Profiles 1 and 2 reflect previous results showing that frail older adults are likely to fall indoors (Profile 1); healthy older adults are likely to fall outdoors (Profile 2). Profile 3 identifies the falls risk for older with mild cognitive impairment living in moderately walkable neighborhoods. Profile 4 identifies the risk found for healthy older adults living in neighborhoods with low walkability.
Neighborhood walkability, in combination with levels of health and functioning, is associated with both indoor and outdoor falls. Descriptive results suggest possible research hypotheses and new directions for prevention, based on individual and neighborhood factors.
探讨邻里因素以及老年人的健康和功能水平是否提示跌倒风险因素的新组合及预防的新方向。探索隶属度（GoM）分析用于进行此项描述性分析的效用。
这是一项对来自加利福尼亚州阿拉米达县、伊利诺伊州库克县、宾夕法尼亚州阿勒格尼县以及北卡罗来纳州韦克县和达勒姆县的884名65岁及以上老年人的横断面描述性研究。访谈聚焦于邻里特征、身体和认知功能、行走以及跌倒和受伤情况。通过GoM分析得出了四种风险概况（个体和邻里因素的高阶相互作用）。
概况1和2反映了先前的结果，即体弱的老年人可能在室内跌倒（概况1）；健康的老年人可能在室外跌倒（概况2）。概况3确定了生活在步行便利性中等的社区中患有轻度认知障碍的老年人的跌倒风险。概况4确定了生活在步行便利性低的社区中的健康老年人的风险。
邻里的步行便利性，连同健康和功能水平，与室内和室外跌倒均相关。描述性结果基于个体和邻里因素提示了可能的研究假设和预防的新方向。
