The Impact of Weather and Seasons on Falls and Physical Activity among Older Adults with Glaucoma: A Longitudinal Prospective Cohort Study

Abstract

Understanding periods of the year associated with higher risk for falling and less physical activity may guide fall prevention and activity promotion for older adults. We examined the relationship between weather and seasons on falls and physical activity in a three-year cohort of older adults with glaucoma. Participants recorded falls information via monthly calendars and participated in four one-week accelerometer trials (baseline and per study year). Across 240 participants, there were 406 falls recorded over 7569 person-months, of which 163 were injurious (40%). In separate multivariable regression models incorporating generalized estimating equations, temperature, precipitation, and seasons were not significantly associated with the odds of falling, average daily steps, or average daily active minutes. However, every 10 °C increase in average daily temperature was associated with 24% higher odds of a fall being injurious, as opposed to non-injurious (p = 0.04). The odds of an injurious fall occurring outdoors, as opposed to indoors, were greater with higher average temperatures (OR per 10 °C = 1.46, p = 0.03) and with the summer season (OR = 2.69 vs. winter, p = 0.03). Falls and physical activity should be understood as year-round issues for older adults, although the likelihood of injury and the location of fall-related injuries may change with warmer season and temperatures.

A methodology for the public health surveillance and epidemiologic analysis of outdoor falls that require an emergency medical services response

“…Best practices guidelines for planting street trees, and for ongoing tree maintenance, to minimize sidewalk damage have been published (MillionTreesNYC 2015 ; Mullaney et al 2015 ).Although sidewalk damage from street trees may increase risk for falls, the cooling effects of trees may prevent some falls. A study among individuals at high risk of falling found that higher temperatures were associated with significantly higher odds of a fall being injurious, as opposed to non-injurious (Vongsachang et al 2021 ). An ecologic study of Census blocks in Marin County CA found that a higher extent of tree canopy cover over streets was associated with lower rates of pedestrian falls among adults age 65 and older (Lee et al 2022 ).…”

“…Unlike indoor falls, which are more likely influenced by an individual's risk factors and health status, outdoor falls are often associated with health-promoting activities (e.g., walking, running, gardening) instead of poor health and are, in particular, substantially influenced by environmental factors, climate (e.g., winter weather, rain and extreme heat) and the physical aspects of the environment such as poorly maintained paving (Chippendale et al Kelsey et al 2012a , 2012b ; Li et al 2006 ; Satariano et al 20172017 ). While icy conditions are a known cause of outdoor falls, there is emerging evidence that injurious outdoor falls are also associated with higher temperatures (Lee et al 2022 ; Vongsachang et al 2021 ).…”

“…A critical first step to developing effective interventions to reduce outdoor falls is to have efficiently generated, robust and reliable surveillance and epidemiological data to characterize the burden of falls, identify high-risk populations, and monitor the distribution of this burden across place and time. Location and temporal differences in fall rates provide the optimal means to examine the role of the environmental, seasonal, temperature, climate and built environment risk factors for outdoor falls (Morency et al 2012 ; Qian et al 2019 ; Vongsachang et al 2021 ).…”

Relation of environmental factors with activity limitations and participation restrictions in older adults with diabetes mellitus over time: an international classification of functioning framework perspective

“…Finally, our findings indicate another environmental factor, seasonal effects, are also risk factors for activity limitations and participation restrictions and predict their changes of slopes within 1 year. Studies have indicated that seasonal changes are associated with specific circulatory disorders and limb weakness [ 54 ] and have varying physiological, psychological, and social function effects on patients over time [ 55 ]. Studies have revealed that environmental factors affect activity limitations and physical and mental impairment [ 56 ] and that participation restrictions in 65-year-olds are related to temperature, especially seasonal temperature changes from September to January [ 54 ].…”

Daily Patterns of Accelerometer-Measured Movement Behaviors in Glaucoma Patients: Insights From UK Biobank Participants

“…Potential confounding factors including age, sex, total annual household income, Townsend deprivation index, smoking, alcohol drinking, education achievement, ethnic background, body mass index, allowance, and employment state at baseline were derived from questionnaires and interviews. As movement behaviors might also fluctuate remarkably among seasons, 25 the month of accelerometer tests was also included in this study. Considering the correlation between glaucoma and other diseases which might also affect movement behaviors, systemic comorbidities including diabetes, coronary heart disease, heart failure, stroke, hypertension, and cancer were identified based on questionnaires, interviews, and inpatient diagnosis records.…”