Sex differences in circumstances and consequences of outdoor and indoor falls in older adults in the MOBILIZE Boston cohort study

Despite extensive research on risk factors associated with falling in older adults, and current fall prevention interventions focusing on modifiable risk factors, there is a lack of detailed accounts of sex differences in risk factors, circumstances and consequences of falls in the literature. We ex...

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Bibliographic Details
Published in:BMC geriatrics 2013-12, Vol.13 (1), p.133-133, Article 133
Main Authors: Duckham, Rachel L, Procter-Gray, Elizabeth, Hannan, Marian T, Leveille, Suzanne G, Lipsitz, Lewis A, Li, Wenjun
Format: Article
Language:English
Subjects:
Accidental Falls - prevention & control
Activities of daily living
Activities of Daily Living - psychology
Age
Aged
Aged, 80 and over
Balance
Boston - epidemiology
Chronic illnesses
Cohort Studies
Environment
Exercise
Falls
Falls (Accidents)
Female
Gender differences
Geriatrics
Humans
Injuries
Male
Medical research
Medicine, Experimental
Older people
Outdoors
Physical fitness
Physiological aspects
Prospective Studies
Questionnaires
Risk factors
Sex Characteristics
Womens health
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Summary:Despite extensive research on risk factors associated with falling in older adults, and current fall prevention interventions focusing on modifiable risk factors, there is a lack of detailed accounts of sex differences in risk factors, circumstances and consequences of falls in the literature. We examined the circumstances, consequences and resulting injuries of indoor and outdoor falls according to sex in a population study of older adults. Men and women 65 years and older (N = 743) were followed for fall events from the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston prospective cohort study. Baseline measurements were collected by comprehensive clinical assessments, home visits and questionnaires. During the follow-up (median = 2.9 years), participants recorded daily fall occurrences on a monthly calendar, and fall circumstances were determined by a telephone interview. Falls were categorized by activity and place of falling. Circumstance-specific annualized fall rates were calculated and compared between men and women using negative binomial regression models. Women had lower rates of outdoor falls overall (Crude Rate Ratio (RR): 0.72, 95% Confidence Interval (CI): 0.56-0.92), in locations of recreation (RR: 0.34, 95% CI: 0.17-0.70), during vigorous activity (RR: 0.38, 95% CI: 0.18-0.81) and on snowy or icy surfaces (RR: 0.55, 95% CI: 0.36-0.86) compared to men. Women and men did not differ significantly in their rates of falls outdoors on sidewalks, streets, and curbs, and during walking. Compared to men, women had greater fall rates in the kitchen (RR: 1.88, 95% CI: 1.04-3.40) and while performing household activities (RR: 3.68, 95% CI: 1.50-8.98). The injurious outdoor fall rates were equivalent in both sexes. Women's overall rate of injurious indoor falls was nearly twice that of men's (RR: 1.98, 95% CI: 1.44-2.72), especially in the kitchen (RR: 6.83, 95% CI: 2.05-22.79), their own home (RR: 1.84, 95% CI: 1.30-2.59) and another residential home (RR: 4.65, 95% CI: 1.05-20.66) or other buildings (RR: 2.29, 95% CI: 1.18-4.44). Significant sex differences exist in the circumstances and injury potential when older adults fall indoors and outdoors, highlighting a need for focused prevention strategies for men and women.
ISSN:1471-2318
1471-2318
DOI:10.1186/1471-2318-13-133