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Outdoor falls among middle-aged and older adults: A neglected public health problem

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Listed:
  • Li, W.
  • Keegan, T.H.M.
  • Sternfeld, B.
  • Sidney, S.
  • Quesenberry Jr., C.P.
  • Kelsey, J.L.

Abstract

Objectives. Although risk factors for indoor falls among older individuals have been well studied, little is known about the etiology of outdoor falls. We examined risk factors for outdoor falls among middle-aged and older adults. Methods. We analyzed data on the most recent fall during the past year among participants aged 45 years and older in the control group (N=2193) of a case-control study of fractures. The study was conducted at 5 Northern California Kaiser Permanente Medical Centers between 1996 and 2001. Results. Falls occurred outdoors more often than indoors among most age groups. Study participants who reported more leisure-time physical activity had a higher risk for outdoor falls, and participants who were in poorer health had a greater risk for indoor falls. Most outdoor falls (73%) were precipitated by environmental factors, such as uneven surfaces and tripping or slipping on objects, and usually occurred on sidewalks, curbs, and streets. Walking (47.3%) was the most common fall-related activity. Conclusions. Outdoor falls among adults aged 45 years and older were frequently attributable to modifiable environmental factors. With the widespread promotion of active lifestyles among older people, improvements in their outdoor environment are urgently needed.

Suggested Citation

  • Li, W. & Keegan, T.H.M. & Sternfeld, B. & Sidney, S. & Quesenberry Jr., C.P. & Kelsey, J.L., 2006. "Outdoor falls among middle-aged and older adults: A neglected public health problem," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1192-1200.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2005.083055_6
    DOI: 10.2105/AJPH.2005.083055
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    Cited by:

    1. Kun Wang & Meijun Chen & Xiaoyue Zhang & Lanchao Zhang & Chun Chang & Yu Tian & Xiaofeng Wang & Zhijing Li & Ying Ji, 2022. "The Incidence of Falls and Related Factors among Chinese Elderly Community Residents in Six Provinces," IJERPH, MDPI, vol. 19(22), pages 1-15, November.
    2. Watkins, A. & Curl, A. & Mavoa, S. & Tomintz, M. & Todd, V. & Dicker, B., 2021. "A socio-spatial analysis of pedestrian falls in Aotearoa New Zealand," Social Science & Medicine, Elsevier, vol. 288(C).
    3. Yi-Ju Tsai & Yi-Ching Yang & Feng-Hwa Lu & Pei-Yun Lee & I-Ting Lee & Sang-I Lin, 2016. "Functional Balance and Its Determinants in Older People with Diabetes," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-11, July.
    4. Clarke, Philippa J. & Ailshire, Jennifer A. & Nieuwenhuijsen, Els R. & de Kleijn - de Vrankrijker, Marijke W., 2011. "Participation among adults with disability: The role of the urban environment," Social Science & Medicine, Elsevier, vol. 72(10), pages 1674-1684, May.
    5. Toby C. T. Mak & Catherine M. Capio & Thomson W. L. Wong, 2022. "Effects of Single-Task, Dual-Task and Analogy Training during Gait Rehabilitation of Older Adults at Risk of Falling: A Randomized Controlled Trial," IJERPH, MDPI, vol. 20(1), pages 1-12, December.
    6. Ghazaleh Delfi & Abdulrahman Al Bochi & Tilak Dutta, 2021. "A Scoping Review on Minimum Foot Clearance Measurement: Sensing Modalities," IJERPH, MDPI, vol. 18(20), pages 1-12, October.
    7. Barbara Resnick & Elizabeth Galik & Ann L. Gruber-Baldini & Sheryl Zimmerman, 2012. "Falls and Fall-Related Injuries Associated With Function-Focused Care," Clinical Nursing Research, , vol. 21(1), pages 43-63, February.
    8. Sungmin Lee & Chanam Lee & Marcia G. Ory, 2019. "Association between Recent Falls and Changes in Outdoor Environments near Community-Dwelling Older Adults’ Homes over Time: Findings from the NHATS Study," IJERPH, MDPI, vol. 16(18), pages 1-12, September.
    9. Emily Joy Nicklett & Matthew C. Lohman & Matthew Lee Smith, 2017. "Neighborhood Environment and Falls among Community-Dwelling Older Adults," IJERPH, MDPI, vol. 14(2), pages 1-15, February.
    10. Margherita Silan & Pietro Belloni & Giovanna Boccuzzo, 2023. "Identification of neighborhood clusters on data balanced by a poset-based approach," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 32(4), pages 1295-1316, October.
    11. Vasoontara Yiengprugsawan & Janneke Berecki-Gisolf & Roderick McClure & Matthew Kelly & Sam-ang Seubsman & Adrian C Sleigh & the Thai Cohort Study Team, 2014. "The Effect of Injuries on Health Measured by Short Form 8 among a Large Cohort of Thai Adults," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-8, February.
    12. Sungmin Lee & Chanam Lee & Susan Rodiek, 2017. "Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers," IJERPH, MDPI, vol. 14(2), pages 1-13, February.
    13. Abdulrahman Al Bochi & Ghazaleh Delfi & Tilak Dutta, 2021. "A Scoping Review on Minimum Foot Clearance: An Exploration of Level-Ground Clearance in Individuals with Abnormal Gait," IJERPH, MDPI, vol. 18(19), pages 1-23, September.
    14. Lava R Timsina & Joanna L Willetts & Melanye J Brennan & Helen Marucci-Wellman & David A Lombardi & Theodore K Courtney & Santosh K Verma, 2017. "Circumstances of fall-related injuries by age and gender among community-dwelling adults in the United States," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-21, May.
    15. Tatiana N. Unguryanu & Andrej M. Grjibovski & Tordis A. Trovik & Børge Ytterstad & Alexander V. Kudryavtsev, 2020. "Weather Conditions and Outdoor Fall Injuries in Northwestern Russia," IJERPH, MDPI, vol. 17(17), pages 1-16, August.
    16. Tong-Yue Zhou & Xiao-Mei Yuan & Xiao-Jun Ma, 2020. "Canan Outdoor Multisurface Terrain Enhance the Effects of Fall Prevention Exercise in Older Adults? A Randomized Controlled Trial," IJERPH, MDPI, vol. 17(19), pages 1-12, September.
    17. Angela Curl & Helen Fitt & Melanie Tomintz, 2020. "Experiences of the Built Environment, Falls and Fear of Falling Outdoors among Older Adults: An Exploratory Study and Future Directions," IJERPH, MDPI, vol. 17(4), pages 1-15, February.
    18. Ana Moradell & Irene Rodríguez-Gómez & Ángel Iván Fernández-García & David Navarrete-Villanueva & Jorge Marín-Puyalto & Jorge Pérez-Gómez & José Gerardo Villa-Vicente & Marcela González-Gross & Ignaci, 2021. "Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study," IJERPH, MDPI, vol. 18(7), pages 1-15, April.
    19. Giulia Ogliari & Jesper Ryg & Karen Andersen-Ranberg & Lasse Lybecker Scheel-Hincke & Tahir Masud, 2022. "Perceived neighbourhood environment and falls among community-dwelling adults: cross-sectional and prospective findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)," European Journal of Ageing, Springer, vol. 19(4), pages 1121-1134, December.

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