Citation

Das Gupta D, Kelekar U, Turner SC. Gerontologist 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Oxford University Press)

DOI

10.1093/geront/gnad139

PMID

37870156

Abstract

BACKGROUND AND OBJECTIVES: Fall incidents from unsafe home environment are frequent in older-adult homes but the literature is ambiguous whether it is the presence/absence, or the interplay of such conditions and physical functioning that is of salience. We therefore estimated whether unsafe home environment adversely associated with subsequent falls among older adults and what proportion of this association was mediated through limitations in daily and instrumental activities of daily living (ADL/IADL). RESEARCH DESIGN AND METHODS: Using a nationally representative sample of community-dwelling Medicare beneficiaries (≥65 years) in the 2018-2019 National Health and Aging Trends Study (NHATS; n=2,599), we conducted bivariate and multivariable analyses. We examined baseline conditions of home disorders, unsafe bathroom settings, unsafe house/building features, and house disrepairs in 2018 and their relation with subsequent falls in 2019, after controlling for covariates. To assess whether ADL/IADL limitations mediated this relationship, we employed the Karlson-Holm-Breen (KHB) methodology.

RESULTS: In 2019, the self-reported prevalence of falls among older adults was estimated at 34.68%. While baseline home disorders had both a direct (adjusted Odds Ratio [aOR]: 1.14, 95% Confidence Interval [CI]:1.03,1.26) and an indirect effect through limitations in ADL and IADL (aOR: 1.01; 95%CI: 1.00,1.03), the relation between unsafe bathroom settings and subsequent falls was unclear. Unsafe house/building features and house disrepairs were not statistically significantly related either directly or indirectly with subsequent falls.

DISCUSSION AND IMPLICATIONS: Addressing home disorders through policy and housing assessments to highlight home environmental safety would be essential to address falls among older adults.

Language: en

Keywords

activities of daily living (ADL); home disorders; instrumental activities of daily living (IADL); NHATS; unsafe bathroom settings