Utilitarian Walking, Neighborhood Environment, and Risk of Outdoor Falls Among Older Adults

Abstract

Objectives Regular walking has been widely recommended to older adults to improve health. We examined the roles of utilitarian and recreational walking in relation to occurrence of outdoor falls in older adults. Methods We analyzed data on walking habits, falls and fall injuries among participants of MOBILIZE Boston, a prospective cohort study of 765 community-dwelling women and men, mainly aged 70 years or older. Neighborhood socioeconomic status (N-SES) indicators were assessed at census block group level. Results Lower N-SES indicators were associated with more utilitarian walking and higher rates for falls on sidewalks, streets, and curbs. Falls on sidewalks and streets were more likely to result in an injury than falls in recreational areas. Utilitarian-only walkers tended to live in neighborhoods with the lowest N-SES, and had the highest rate of outdoor falls despite walking 14 and 25 fewer blocks per week than the recreational-only and dual walkers, respectively. Conclusions Improving the safety of walking environments in areas where older adults shop and do other errands of necessity is an important component of fall prevention.

Neighborhood Disadvantage and Life‐Space Mobility Are Associated with Incident Falls in Community‐Dwelling Older Adults

“…Poorer neighborhoods also often have lower‐quality parks and open spaces that present potential fall hazards and impede the maintenance of fitness and balance skills . In contrast to participants in the previous study, those in the current study were a more‐balanced biracial cohort (50% white) and had greater representation of individuals with fewer years of education (73% ≤high school graduate) than in the previous study (78% white; 34% ≤high school graduate). These findings therefore add to the literature by demonstrating the contribution of neighborhood disadvantage to fall risk in older adults in the community but with findings that are more generalizable to a broader population across the racial and socioeconomic spectrum.…”

Racial differences in eating patterns and food purchasing behaviors among urban older women

“…Each person’s single composite score used in the adjusted regression model was then predicted as the sum of all the products of each specific regression coefficient multiplied by her value of the corresponding characteristic. 22 …”

A comprehensive fracture prevention strategy in older adults: The European union geriatric medicine society (EUGMS) statement

“…The studies are however insufficiently powered to demonstrate a significant effect on hip fracture risk (21,24,30). Single interventions including treatment of some vision problems or carotid sinus hypersensitivity, vitamin D supplementation in deficient patients, gradual withdrawal of psychotropic medication, or improving the safety of indoor activities and outdoor walking environments are also effective for suitable patient groups in the prevention of falls, but the effect on fracture risk is not clear (21,32,33). Multifactorial interventions, a combination of interventions linked to the individual's risk profile, seem no more effective in preventing falls than single targeted interventions (e.g.…”

“…Other interventions have been ineffective or inconsistent for falls although the rate of recurrent falls may be reduced (35). A multifactorial and interprofessional approach, determined by individual assessment of functional, medical, and social concerns, may be a more appropriate strategy to prevent falls in older people at high risk of falling (20,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)36). Moreover, this tailored approach (37) may provide opportunities to address previously unidenti ed health problems (e.g.…”