The risk factors for indoor and outdoor falls for older adults are different, according to a new study.
Researchers at the Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School, reported a fact that is often missed when the two are combined. Their findings may affect how falls prevention programs are structured.
The scientists noted that indoor and outdoor falls are both important. But they note that people at high risk for indoor falls are different in many ways from those at high risk of outdoor falls.
The findings which were published online in the Journal of the American Geriatrics Society, found that indoor falls are associated with an inactive lifestyle, disability, and poor health, while outdoor falls are associated with higher levels of activity and average or better-than-average health.
Older adults who fell outdoors were somewhat younger than those who fell indoors, more likely to be male and better educated, and had lifestyle characteristics indicative of better health. Those who fell indoors had more physical disabilities, took more medications, and had lower cognitive function than those who fell outdoors.
The study examined nearly 800 men and women, age 70 and older, from randomly sampled households in the Boston area. Study participants underwent a comprehensive baseline falls assessment, including a home visit and clinic examination. Falls were reported on monthly calendars submitted to the researchers. Over a nearly two-year period, 598 indoor falls and 524 outdoor falls were reported. When a participant reported a fall, a structured telephone interview was conducted to determine the circumstances.
A fall the scientists report is not necessarily a marker of poor health. In fact, almost half of all falls occurred outdoors, and people who fell outdoors had the same or better health than those who did not fall at all. Second, epidemiological studies of risk factors for falls in older people may be hampered when falls are combined, with important associations between risk factors and indoor and outdoor falls potentially being missed. Third, intervention programs need to be tailored differently for people more likely to fall outdoors than those who tend to fall indoors.
According to the American Association for Long-Term Care Insurance, seniors who fall suffer moderate to severe injuries, including hip fractures and traumatic brain injuries. At least half of these falls occur outdoors. Falls are a leading cause for needing long-term care.
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