Arias-Fernández Lucía, Carcedo-Argüelles Lucía, García-Esquinas Esther, Caballero Francisco Félix, Rodríguez-Artalejo Fernando, Lana Alberto
Department of Medicine, Universidad de Oviedo/ISPA, Oviedo, Spain.
National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
Arch Gerontol Geriatr. 2025 Jun;133:105831. doi: 10.1016/j.archger.2025.105831. Epub 2025 Mar 16.
To explore the prospective association between physical environment characteristics of the neighborhood and risk of falls/fear of falling among community-dwelling older adults.
Prospective cohort analysis using data from the Seniors-ENRICA-2 cohort (metropolitan Madrid, Spain).
At baseline (2015-17), a neighborhood physical characteristics score was developed using the Physical Activity Neighborhood Environment Scale and an additional indicator of distance to green areas. In the second wave of follow-up (2019-20) we collected self-reported incident falls and fear of falling, assessed with the Short Falls Efficacy Scale International. Adjusted odds ratios (OR) and 95 % confidence intervals (CI) for the association between neighborhood environment perception and incidence of falls/fear of falling were calculated using logistic regression.
Among 1823 participants, 27.7 % reported a fall during the previous year and 32.1 % were concerned about having a fall. Better neighborhood environment was associated with lower risk of falls (OR: 0.75; 95 %CI: 0.57-0.99) and fear of falling (0.73; 0.55-0.96). Specifically, low traffic intensity (0.68; 0.52-0.90) and sidewalks in good condition (0.75; 0.59-0.95) were associated with lower risk of falling. Moreover, available facilities for biking (0.77; 0.61-0.96), sidewalks in good condition (0.67; 0.52-0.86), night security (0.80; 0.60-0.99) and day security (0.62; 0.44-0.98) were independently associated with lower fear of falling.
Better neighborhood physical environments could play a key role in the prevention of falls and fear of falling among older adults. Policies aiming to improve residential environments can have broad implications for achieving healthy aging.
探讨社区居住的老年人邻里物理环境特征与跌倒风险/跌倒恐惧之间的前瞻性关联。
使用来自老年人 - ENRICA - 2队列（西班牙马德里市）的数据进行前瞻性队列分析。
在基线（2015 - 17年）时，使用身体活动邻里环境量表和到绿地距离的附加指标制定邻里物理特征评分。在第二轮随访（2019 - 20年）中，我们收集了自我报告的跌倒事件和跌倒恐惧情况，使用国际简短跌倒效能量表进行评估。使用逻辑回归计算邻里环境感知与跌倒/跌倒恐惧发生率之间关联的调整优势比（OR）和95%置信区间（CI）。
在1823名参与者中，27.7%报告上一年有跌倒，32.1%担心跌倒。更好的邻里环境与较低的跌倒风险（OR：0.75；95%CI：0.57 - 0.99）和跌倒恐惧（0.73；0.55 - 0.96）相关。具体而言，低交通强度（0.68；0.52 - 0.90）和状况良好的人行道（0.75；0.59 - 0.95）与较低的跌倒风险相关。此外，可用的自行车设施（0.77；0.61 - 0.96）、状况良好的人行道（0.67；0.52 - 0.86）、夜间安全（0.80；0.60 - 0.99）和日间安全（0.62；0.44 - 0.98）与较低的跌倒恐惧独立相关。
更好的邻里物理环境可能在预防老年人跌倒和跌倒恐惧方面发挥关键作用。旨在改善居住环境的政策对实现健康老龄化可能具有广泛影响。
