Assessing hazards and associated fall risks among elderly population: a cross-sectional study of different residential settings in Karachi, Pakistan.

Abstract

Background: Safety is one of the top priorities in caring for elderly people because they gradually lose their functional ability with age and are more vulnerable to injuries. Therefore, ensuring safety needs in one's own residential settings is crucial; however, public awareness of home hazards and associated risks of falls is limited. The current study assessed the hazards and associated risks of falling in various residential settings across Karachi, Pakistan.

Methods: A total of 166 participants were recruited: 54 from old age homes, 58 from single-unit houses, and 54 from apartments for this cross-sectional study using the convenience sampling method. The study was conducted in 2022 for nine months. Data were gathered using the Home Falls and Accident Screening Tool. During the visit, the researcher asked questions related to demographics, history of falls and then completed HOME FAST by directly observing their home environment and elderly people while they performed their functional tasks at their residence. Independent-Samples Kruskal-Wallis test, chi-square test and cross tabulation were used for statistical analysis.

Results: The median age of the elderly people was 65 years (IQR: 62-70 years). Approximately 22.3% of the participants reported falls in the last 12 months. Among 25 hazards, the most prevalent were lack of bath/shower grab rails, non-slip mats, lack of access to a bedside light, and slippery floor surfaces, where median number of hazards was 5 (IQR: 4-6) indicating a moderate level of risk of hazards. Moreover, a significant difference (P < 0.007) in risk of hazards scores was observed among old age homes, single-unit houses, and apartments. In addition, out of the 25 identified hazards between Fallers vs. Non-Fallers, six hazards; including difficulty in carrying meals, lack of non-slip mats in the bathroom, difficulty during bed transfers, lack of bath/shower grab rails, difficulty during toilet transfers, and reaching difficulties towards kitchen items, were significantly associated with falls.

Conclusions: This study found that identified hazards in residential settings are significantly associated with the risk of falls and can compromise the functional ability, safety, and health of elderly people. Therefore, preventive measures should be taken to reduce hazards and fall incidence to promote safety and independence in daily activities.