Domiciliary environmental risk factors for accidental falls among community‐living older persons: A prospective 12‐month study

Background: Falls are common internationally among the elderly. This study examined domiciliary environmental risk factors attributable to accidental falls among community‐living older persons living in highrise buildings in Hong Kong. Methods: Over the preceding 6 months, 592 older persons were recruited from a housing resource center for baseline assessments. Among them, 456 participants completed monthly telephone follow‐ups for 12 months. A home visit for environmental inspection was conducted within 3 days for those who reported falls in an indoor environment. The environments of participants with or without falls were compared for analysis. Results: Seventy‐seven participants reported falls (indoor: outdoor = 1:2) over the preceding 12 months. The fall rate was 24.8%, and the one‐year prevalence of falls (persons with at least one fall) was 16.7%; for two or more falls it was 3.9%. Self‐reported previous falls in the preceding 12 months (OR 2.88, CI 1.67‐7.17), female gender (OR 8.91, CI 0.27‐0.47), and self‐reported diabetes mellitus (OR 3.55, CI 1.10‐3.55) were significant predictors for fallers with at least one fall. Significant differences were found between the homes of fallers and non‐fallers in the sites of hazards with respect to seating (p = .011), toilets (p = .018), and kitchens (p = .026), particularly with steps or stair railings (p = .009). Conclusions: This study supports the existence of a difference in environmental risk factors between fallers and non‐fallers in high‐rise buildings, and the results can be generalized to other domiciliary environments for community‐living older persons in most urban cities.