College of Nursing, University of Central Florida, Orlando, FL, USA.
Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA.
Health Soc Care Community. 2022 Jan;30(1):253-263. doi: 10.1111/hsc.13398. Epub 2021 Apr 24.
Falls impose substantial health and economic burdens on older adults. Over half of falls in older adults occur at home, with many involving bathroom areas. Limited information is available on the presence of bathroom modifications for those who experience them. Therefore, we examined factors associated with bathroom modifications among older adults with at least one fall in the United States. We analysed the nationally representative 2016 Medicare Current Beneficiary Survey Public Use File of Medicare beneficiaries aged ≥65 years with ≥1 fall (n = 2,404). A survey-weighted logistic model was used to examine associations between bathroom modifications and factors including socio-demographic characteristics, health-related conditions, and fear of falling. Among Medicare beneficiaries with ≥1 fall, 55.5% had bathroom modifications and 50.1% had repeated falls (≥2 falls). Approximately 40.2% of those with repeated falls had no bathroom modifications. In the adjusted model, non-Hispanic Blacks (odds ratio [OR] = 0.38; p < 0.001) and Hispanics (OR = 0.64; p = 0.039) had lower odds of having bathroom modifications than non-Hispanic Whites. Fear of falling and activities of daily living limitations had incremental impacts on having bathroom modifications. This study highlights the need to improve disparities in bathroom modifications for non-Hispanic Black and Hispanic Medicare beneficiaries, including those with repeated falls. With the aging population and growing number of older minorities in the United States, reducing these disparities is vital for fall prevention efforts and aging-in-place.
老年人跌倒会带来严重的健康和经济负担。超过一半的老年人跌倒发生在家庭中，其中许多涉及浴室区域。对于那些经历过跌倒的人，关于浴室改造的信息有限。因此，我们在美国研究了与至少一次跌倒的老年人浴室改造相关的因素。我们分析了全国代表性的 2016 年医疗保险当前受益人调查公共使用文件，该文件包括≥65 岁、至少有一次跌倒的医疗保险受益人的信息（n=2404）。使用调查加权逻辑模型来研究浴室改造与包括社会人口特征、健康相关状况和跌倒恐惧等因素之间的关联。在至少有一次跌倒的医疗保险受益人中，55.5%的人进行了浴室改造，50.1%的人发生了重复跌倒（≥2 次跌倒）。大约 40.2%的重复跌倒者没有进行浴室改造。在调整后的模型中，非西班牙裔黑人（比值比[OR] = 0.38；p<0.001）和西班牙裔（OR = 0.64；p = 0.039）进行浴室改造的可能性低于非西班牙裔白人。对跌倒的恐惧和日常生活活动的限制对进行浴室改造的可能性有增量影响。这项研究强调了需要减少非西班牙裔黑人和西班牙裔医疗保险受益人的浴室改造差异，包括那些重复跌倒的人。随着美国人口老龄化和老年少数族裔人数的增加，减少这些差异对于预防跌倒和就地养老至关重要。
