Perceived Neighborhood Fall Risks and Strategies Used to Prevent Outdoor Falls: Does Age Matter?

SIGNIFICANCE: To enable “aging in place,” research and practice that promote the health and wellness of community-dwelling seniors are needed. Given that outdoor falls are common and can cause injuries that result in disability and decreased quality of life, research in this area of inquiry is vital.

INNOVATION: Outdoor falls are just as common as indoor falls, yet the focus of falls prevention has been on intrinsic factors and the home environment. This study provides new information regarding differences in perceived fall risk and strategies used to prevent outdoor falls among younger versus older age groups. Results can help occupational therapists (OTs) to design effective and targeted fall-prevention programs.

APPROACH: Our purpose in this study was to explore differences in perceived neighborhood fall risks and strategies used for outdoor fall prevention among seniors over and under 75 yr of age. The neighborhood environment has received less attention in both epidemiological and intervention studies on falls. Risk factors for outdoor falls differ from those for indoor falls and include being younger. Therefore, a comparison of perceived neighborhood fall risks and strategies used by younger versus older seniors to prevent outdoor falls is called for.

METHOD: Fourteen seniors, aged 65 yr and older, from three urban senior centers participated in the study. The results of a semistructured interview and background questionnaire were analyzed with a mixed-methods matrix. We developed the background questionnaire and interview guide on the basis of the literature and an existing measure of walkability. Both tools were piloted with community-dwelling seniors and were modified on the basis of interviewer feedback. We used a mixed-methods matrix to concurrently analyze quantitative and qualitative results. Analyzed “cases” consisted of two groups: seniors above and below 75 yr of age. Collaizzi’s phenomenological analysis method was used for qualitative analysis. Two coders were used to increase reliability of the findings. Descriptive quantitative analysis was conducted with SPSS Version 21.

RESULTS: Both groups identified a number of perceived fall risks, but the younger age group used fewer fall-prevention strategies. Some perceived fall risks and strategies used for prevention were convergent. However, the younger age group identified the social environment as a risk factor for falls and used the social environment differently with regard to prevention strategies.

CONCLUSION: Results suggest subtle differences in perceived fall risks and number and type of strategies used for fall prevention among older versus younger age groups. Findings illustrate the need to evaluate the neighborhood environment when considering fall risk. Targeted fall-prevention programs specific to a client’s functional level and age group are needed, as is the promotion of greater awareness of outdoor fall risks. Study limitations include the use of self-report and retrospective data collection as well as a small sample size with regard to quantitative analysis.

References

Kelsey, J. L., Berry, S. D., Procter-Gray, E. , Quach, L., Nguyen, U.-S. D. T., Li, W., … Hannan, M. T. (2010). Indoor and outdoor falls in older adults are different: The maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. Journal of the American Geriatrics Society, 58, 2135–2141. http://dx.doi.org/10.1111/j.1532-5415.2010.03062.x