Department of Plant Science and Landscape Architecture, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT, USA.
Department of Landscape Architecture & Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA.
Aging Ment Health. 2020 Dec;24(12):1968-1976. doi: 10.1080/13607863.2019.1647139. Epub 2019 Jul 31.
Fear of falling is a major health concern among older adults. Although several studies have addressed general fear of falling in relation to personal factors, little is known about the specific relationship between fear of outdoor falling and perceptions of the outdoor environments.
This study is to identify perceived environmental factors and outdoor exposure associated with fear of outdoor falling among assisted living residents aged 65 or older stratified by the amount of time spent outdoors.
This study used survey data collected from a multiregional study conducted in 2007 that surveyed residents in 68 assisted living facilities in Houston, Texas; Chicago, Illinois; and Seattle, Washington. Out of 1,043 total participants, this study used a subset of 907 residents who used outdoor areas at least five minutes a day. Multivariate logistic regression was used after controlling for covariates.
Approximately 31% of the participants reported having worried about falling while using the outdoor areas in their assisted living community. Multivariate analyses showed that adequately designed walkways (OR = 0.614, 95% CI = 0.405-0.931), comfort levels in using outdoor areas (OR = 0.657, 95% CI = 0.437-0.989), and frequency of outdoor usage (OR = 0.538, 95% CI = 0.368-0.787) were associated with decreased fear of outdoor falling after adjusting for individual factors (i.e. age, sex, health condition, fall history, vision problems, mobility aids).
Improved walkways and comfort levels when using outdoor areas, as well as the amount of time spent outdoors, would be helpful in reducing fear of outdoor falling, which can help promote healthy lifestyle among assisted living residents.
跌倒恐惧是老年人的主要健康问题。虽然有几项研究探讨了与个人因素有关的一般性跌倒恐惧，但对于户外跌倒恐惧与户外环境感知之间的具体关系知之甚少。
本研究旨在确定与 65 岁及以上的辅助生活居民的户外跌倒恐惧相关的感知环境因素和户外活动，并根据户外活动时间进行分层。
本研究使用了 2007 年进行的一项多区域研究中的调查数据，该研究调查了德克萨斯州休斯顿、伊利诺伊州芝加哥和华盛顿州西雅图的 68 个辅助生活设施中的居民。在总共 1043 名参与者中，本研究使用了每天至少使用户外区域 5 分钟的 907 名居民的一个子集。在控制了协变量后，使用多变量逻辑回归进行分析。
大约 31%的参与者报告在使用辅助生活社区的户外区域时担心跌倒。多变量分析表明，设计合理的步道（OR=0.614，95%CI=0.405-0.931）、在户外区域使用的舒适度（OR=0.657，95%CI=0.437-0.989）和户外活动的频率（OR=0.538，95%CI=0.368-0.787）与调整个人因素（即年龄、性别、健康状况、跌倒史、视力问题、助行器使用）后降低户外跌倒恐惧相关。
改善步道和户外区域使用时的舒适度，以及户外活动的时间，有助于降低户外跌倒恐惧，从而有助于促进辅助生活居民的健康生活方式。
