Urban-Rural Dimension of Falls and Associated Risk Factors among Community-Dwelling Older Adults in West Java, Indonesia

Abstract

Falls are one of the common problems among older adults; it is estimated that 684,000 fatal cases of falls occur every year. Furthermore, falls constitute one of the leading causes of mortality due to accidental injury. This study aims to identify the risk factors for falls in the older adults who live in the community, according to the dimensions of the living area: in urban and rural. The proportional sampling method was used to identify the rural and urban areas in West Java Prefecture; meanwhile, the incidence of fall in the last 12 months was selected as the outcome variable. Furthermore, sociodemographic background, chronic medical condition, fear of falling, visual and hearing impairments, Activity of Daily Living (ADL), Barthel index, physical performance (Short Performance Physical Battery (SPPB)), and living environment were analyzed to identify the risk factors that contribute to the incidence of falls. A total of 611 older adults participated in this study: 62% of them are living in rural area and 38% of them are living urban areas. More than 70% of study participants were aged 60–69 years, while 73% were females. There is no significant difference in fall prevalence in rural (16.5%) and urban (10.7%) areas ( p value = 0.228). Furthermore, the multiple logistic regression analysis showed that the male gender (OR = 0.29, 95%CI [0.09–0.88]), chronic illness (OR = 3.25, 95%CI [1.24–8.53]), and visual impairment (OR = 3.6, 95%CI [1.52–8.54]) were associated with fall among older adults in urban areas. Meanwhile, visual impairment (OR = 1.81, 95%CI [1.03–3.18]) and living environment (OR = 3.36, 95% CI [1.14–9.93]) were significantly associated with falls in rural areas. Based on the associated risk factors identified in this study, a different approach is needed to reduce the falling risk among older adults in urban and rural areas in Indonesia.

Associations of Household Solid Fuel Use With Falls and Fall-Related Injuries in Middle-Aged and Older Population in China: A Cohort Study

“…Falls are the second leading cause of accidental injury deaths worldwide; there are approximately 684,000 fatal falls in the world every year, more than 80% of which happen in low-and middleincome countries, usually involving people who are older and more dependent [1]. More than 2.8 million people are treated in emergency departments because of falls every year, and a quarter of falls cause serious injuries, such as fractures or brain injury [2].…”

The Changing Incidence and Prevalence of Falls and Its Disability Burden Among the Geriatric Population in Saudi Arabia from 1990 to 2019: A Longitudinal Analysis Using Global Burden of Disease Study Data

“…As the leading cause of injury-related death in adults 60 and older, falls, for example, contributed to over 38,000 fatalities in 2020 in the United States [ 4 ]. Worldwide, 684,000 fatal falls occur annually, ranking second to road traffic injuries among unintentional injury-related deaths [ 5 ].…”

“…With a population of 34 million, Saudi Arabia is undergoing a substantial demographic shift marked by an expanding aging population [ 5 ]. In 2020, over two million individuals aged 60 and older comprised more than 6% of the population, with projections indicating that this number will exceed 11 million by 2050, accounting for 24% of the population [ 8 ].…”

Comparing well-being among rural and urban Indonesian older people: a quantitative analysis of the related factors

“…Most of the currently available studies comparing rural and urban older adults in Indonesian focus on socio-culture or physical health issues [18], [19]. To our knowledge, there has been no published study that compared the well-being nor well-being determinants between rural and urban community-dwelling older people in Indonesia.…”