Citation

Lee S, Lee C, Ory MG, Won J, Towne SD, Wang S, Forjuoh SN. Gerontologist 2018; 58(6): 1065-1074.

Affiliation

Department of Family & Community Medicine, Baylor Scott & White Health, College of Medicine, Texas A&M Health Science Center, Temple.

Copyright

(Copyright © 2018, Oxford University Press)

DOI

10.1093/geront/gnx123

PMID

28958081

Abstract

BACKGROUND AND OBJECTIVES: Fear of falling is a substantial barrier to walking and has been associated with increased fall risks. This study examines neighborhood environmental risk factors related to fear of outdoor falling in middle-aged and older adults. RESEARCH DESIGN AND METHODS: A total of 394 participants aged 50 years or older living independently in the community were recruited between 2013 and 2014 from an integrated health care network serving Central Texas. Fear of outdoor falling and perceived neighborhood environmental variables were assessed using self-reported questionnaires. Logistic regression identified perceived neighborhood environmental variables associated with fear of outdoor falling.

RESULTS: Sixty-nine (17.9%) of 385 participants reported having a fear of outdoor falling. Compared to those who did not report a fear of outdoor falling, those who reported having a fear of outdoor falling were more likely to be adults aged 65 years or older (odds ratio [OR] = 2.974, 95% confidence interval [CI] = 1.247-7.094), be female (OR = 4.423, 95% CI = 1.830-10.689), have difficulty with walking for a quarter of a mile (OR = 2.761, 95% CI = 1.124-6.782), and have had a fall in the past year (OR = 4.720, 95% CI = 1.472-15.137). Among the neighborhood environmental characteristics examined, low traffic speed on streets (OR = 0.420, 95% CI = 0.188-0.935), drainage ditches (OR = 2.383, 95% CI = 1.136-5.000), and broken sidewalks (OR = 3.800, 95% CI = 1.742-8.288) were associated with the odds of having a fear of outdoor falling.

DISCUSSION AND IMPLICATIONS: In addition to the individual factors, findings from this study suggest the importance of addressing the environmental risk factors in identifying and reducing fear of outdoor falling among middle-aged and older adults.

Language: en

Keywords

Built environment; Fear of falling; Social environment