@article{3370349958314a028486de35a72c8e5d,
title = "Association between recent falls and changes in outdoor environments near community-dwelling older adults{\textquoteright} homes over time: Findings from the NHATS study",
abstract = "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.",
keywords = "Elderly, Falls, Outdoor environmental characteristics",
author = "Sungmin Lee and Chanam Lee and Ory, {Marcia G.}",
note = "Funding Information: The data for the present study were taken from the National Health and Aging Trends Study (NHATS), which is an ongoing longitudinal study that surveys a nationally representative sample of 35.3 million Medicare beneficiaries aged 65 or older who reside in the United States [24]. The sample frame of NHATS relies on Medicare enrollment data and receives funding from the National Institute on Aging (NIA). Data were collected by trained personnel through in-person interviews and assessments. From 12,411 selected individuals, 8245 agreed to participate in the survey (weighted response rate = 71.6%) at baseline. At the 1-year follow-up, 6113 individuals who had responded in round one participated in the survey (weighted response rate = 84.9%) p [25]. Since our study sought to investigate the relationship between falling and outdoor environments near the home among community-dwelling residents, we excluded respondents who resided in nursing homes (n = 468) or similar care facilities (n = 412) and proxy respondents (n = 517), resulting in a sample of 6680 community-dwelling older adults at baseline. At the 1-year follow-up, 5659 of the 6680 respondents were interviewed again. We excluded those who had moved to non-community-dwelling housing (n = 332), resulting in 5327 participants. Finally, we excluded participants who reported never going outside (n = 36) at baseline because our study focus was on the risk of falling in outdoor environments, leaving 5291 participants for the final sample. Of the 5291 participants, 4802 (90.8%) reported no recent falls at baseline and so were included in the study analyses. Funding Information: Acknowledgments: This study uses data collected from the National Health and Aging Trends Study sponsored by the National Institute on Aging (NIAU01AG032947) through a cooperative agreement with the Johns Hopkins Bloomberg School of Public Health. Publisher Copyright: {\textcopyright} 2019 by the authors. Licensee MDPI, Basel, Switzerland.",
year = "2019",
month = sep,
day = "2",
doi = "10.3390/ijerph16183230",
language = "English (US)",
volume = "16",
journal = "International journal of environmental research and public health",
issn = "1661-7827",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "18",
}