Fall Prevention Strategies Depend on Indoor, Outdoor Risk Factors

Older adults have different risk factors when it comes to indoor and outdoor falls. This subtle variation is often ignored and should affect how fall prevention programs are structured, study says.

"Indoor and outdoor falls are both important, but people at high risk for indoor falls are different in many ways from those at high risk of outdoor falls," says Marian T. Hannan, lead author of the study by the Institute for Aging Research of Hebrew SeniorLife. "Failure to separate the two can mask important information on risk factors and may hamper the effectiveness of falls prevention programs."

The study, published in the Journal of the American Geriatrics Society, found that indoor falls are associated with an inactive lifestyle, disability, and poor health, while outdoor falls are associated with higher levels of activity and average or better-than-average health.

Older adults who fell outdoors were somewhat younger than those who fell indoors, more likely to be male and better educated, and had lifestyle characteristics indicative of better health. Those who fell indoors had more physical disabilities, took more medications, and had lower cognitive function than those who fell outdoors.

The study examined 765 men and women, age 70 and older, randomly selected in the Boston area, all of whom underwent a baseline falls assessment, including a home visit and clinic examination. Over a nearly two-year period, 598 indoor falls and 524 outdoor falls were reported, and study participants were interviewed to determine the causes.