Environmental and physical factors predisposing middle-aged and older Japanese adults to falls and fall-related fractures in the home.

ABSTRACT

AIM: To identify environmental and physical factors that predispose middle-aged and older Japanese adults to falls and fall-related fractures in the home. METHODS: A cross-sectional survey was carried out in 2014. Self-administered questionnaires were distributed to 15 000 community-dwelling adults in Japan. The overall crude response rate was 13%. Response data were analyzed from 1561 individuals aged ≥40 years using multiple imputation to analyze missing data. We evaluated falls without fractures and fall-related fractures during the previous 3 years according to demographic, physical and environmental factors, including age, sex, long-term care insurance certification, type of house and barrier-free housing. RESULTS: Of the 1561 adults (mean age 68.1 ± 13.0 years), 28% experienced a fall in the home. Among the individuals who experienced a fall, 11% experienced fall-related fractures. These individuals were more likely to be women (OR 2.4, 95.0% CI 1.1-5.1), have LTCI certification (OR 3.9, 95.0% CI 1.6-9.4) and be living in a barrier home (OR 4.0, 95.0% CI 1.6-9.8), after adjustment for covariates. CONCLUSIONS: Environmental factors, such as living in a barrier home, are critical for fall-related fractures, in addition to demographic and physical factors. A multidisciplinary approach that considers both physical and environmental factors is necessary for reducing the incidence of fall-related fractures among middle-aged and older Japanese adults. Geriatr Gerontol Int 2018; 18 1372-1377.