Department of Plant Science and Landscape Architecture, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT 06268, USA.
Department of Landscape Architecture & Urban Planning, College of Architecture, Texas A&M University, College Station, TX 77843, USA.
Int J Environ Res Public Health. 2019 Sep 4;16(18):3230. doi: 10.3390/ijerph16183230.
Neighborhood environments have been increasingly associated with incidents of falling and the fear of falling. However, little is known about the causal impact of neighborhood environments on falling. This study identifies whether changes in outdoor environmental attributes over a one-year period are associated with the occurrence of recent falls among community-dwelling older adults aged 65 and older in the United States. Data were obtained from 4802 adults aged 65 years or older from the National Health and Aging Trends Study (NHATS). Logistic regression analyses were performed to identify neighborhood risk factors linked to the odds of experiencing recent falls at the one-year follow-up. Almost one in ten subjects (9.7% of 4802 subjects) who had not fallen before reported experiencing recent falls after one year. After adjusting for sociodemographic, health, and walking-related behavioral covariates, these subjects were more likely to reside in areas with higher environmental barriers on sidewalks/streets and uneven walking surfaces or broken steps, compared to non-fallers. Our findings suggest that safe and well-maintained outdoor environments may help prevent falls among community-dwelling older adults who engage in outdoor activities. Clinical and environmental interventions for promoting both safe walking and safe environments are warranted.
社区环境与跌倒和跌倒恐惧事件的发生日益相关。然而，对于社区环境对跌倒的因果影响知之甚少。本研究旨在确定美国 65 岁及以上社区居住的老年人在一年时间内户外环境属性的变化是否与近期跌倒的发生有关。研究数据来自国家健康老龄化趋势研究（NHATS）的 4802 名 65 岁及以上的成年人。采用逻辑回归分析来确定与一年后近期跌倒风险相关的邻里危险因素。在随访一年后，近十分之一（4802 名受试者中的 9.7%）之前没有跌倒的受试者报告出现近期跌倒。在调整了社会人口统计学、健康和与行走相关的行为协变量后，与非跌倒者相比，这些受试者更有可能居住在人行道/街道和不平坦的行走表面或破损台阶等环境障碍物较高的区域。我们的研究结果表明，安全且维护良好的户外环境可能有助于预防参与户外活动的社区居住的老年人跌倒。需要开展针对安全行走和安全环境的临床和环境干预措施。
