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

BMC Geriatrics

Wenjun Li²  Lewis A Lipsitz³  Suzanne G Leveille¹  Marian T Hannan³  Elizabeth Procter-Gray²  Rachel L Duckham² 

[1] College of Nursing and Health Sciences, University of Massachusetts, 100 Morrissey Blvd, Boston, MA 02125-3393, USA;Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Shaw SH2-230, 55 Lake Avenue North, Worcester, MA, USA;Institute for Aging Research, Hebrew SeniorLife /Harvard Medical School, and Beth Israel Deaconess Medical Center, 1200 Centre Street, Boston, MA 02131-1097, USA

关键词: Gender;    Sex;    Space use;    Physical activity;    Aging;    Injury;    Falls;   

Others  :  856593
DOI  :  10.1186/1471-2318-13-133

 received in 2013-07-02, accepted in 2013-11-29,  发布年份 2013

【 摘 要 】

Background

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.

Methods

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.

Results

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).

Conclusions

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.

【 授权许可】

   
2013 Duckham et al.; licensee BioMed Central Ltd.

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