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Aparecida Damasceno D, Ferreira Aleixo G, Barbosa Luciano J, Nogueira CM, Pinto JM. Factors Related to Recurrent Falls Among Older Adults Attending Primary Health Care: A Biopsychosocial Perspective. Exp Aging Res 2024; 50:348-359. [PMID: 36974688 DOI: 10.1080/0361073x.2023.2195293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 02/24/2023] [Indexed: 03/29/2023]
Abstract
The objective of this study was to investigate factors related to recurrent falls among older adults attending primary health care, considering the biopsychosocial perspective. A representative sample of 201 older adults were interviewed in three Primary Health Care units randomly selected in a city in southeastern Brazil. Outcome included self-report of two or more falls in the past 12 months. Exposures included personal and environmental aspects, according to domains of International Classification of Functioning of the World Health Organization (ICF-WHO). Recurrent falls were reported by 24.4% of the participants. Associations with depressive symptoms (p = .003), having osteoporosis (p = .031), chronic musculoskeletal pain (p = .020), frailty (p = .013), sleep satisfaction (p < .001), and functional status (p < .001) were found. In logistic regression models, cognitive status, musculoskeletal pain, and functional status were predictors of recurrent falls; however, only sleep satisfaction remained significant in the final model. Strategies aimed at preventing recurrent falls in primary health care should consider assessments and interventions targeting sleep aspects among older adults.
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Affiliation(s)
| | - Gabriel Ferreira Aleixo
- Undergraduate Program in Physical Therapy, Federal University of Triangulo Mineiro, uberaba, Brazil
| | - Jean Barbosa Luciano
- Undergraduate Program in Physical Therapy, Federal University of Triangulo Mineiro, uberaba, Brazil
| | - Claudio Mardey Nogueira
- Graduate Program in Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - Juliana Martins Pinto
- Laboratory of Physical Therapy and Public Health - Department of Physical Therapy - Institute of Health Science, Federal University of Triangulo Mineiro, Uberaba, Brazil
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Sebastiani C, Wong JYX, Litt A, Loewen J, Reece K, Conlin N, Dunand T, Montero Odasso M, D'Amore C, Saunders S, Beauchamp M. Mapping sex and gender differences in falls among older adults: A scoping review. J Am Geriatr Soc 2024; 72:903-915. [PMID: 38147460 DOI: 10.1111/jgs.18730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/02/2023] [Accepted: 11/19/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND There is growing recognition of the importance of sex and gender differences within falls literature, but the characterization of such literature is uncertain. The aim of this scoping review was to (1) map the nature and extent of falls literature examining sex or gender differences among older adults, and (2) identify gaps and opportunities for further research and practice. METHODS We used a scoping review methodology. Eligible studies included participants with a mean age of ≥ 60 years and study aims specifying falls and either sex or gender concepts. MEDLINE, Embase, CINAHL, Ageline, and Psychinfo databases were searched from inception to March 2, 2022. Records were screened and charted by six independent reviewers. Descriptive and narrative reports were generated. RESULTS A total of 15,266 records were screened and 74 studies were included. Most studies reported on sex and gender differences in fall risk factors (n = 52, 70%), incidence/prevalence (n = 26, 35%), fall consequences (n = 22, 30%), and fall characteristics (n = 15, 20%). The majority of studies (n = 70, 95%) found significant sex or gender differences in relation to falls, with 39 (53%) identifying significant sex differences and 31 (42%) identifying significant gender differences. However, only three (4%) studies defined sex or gender concepts and only nine (12%) studies used sex or gender terms appropriately. Fifty-six (76%) studies had more female participants than males. Four (5%) were intervention studies. Studies did not report falls in line with guidelines nor use common fall definitions. CONCLUSION Sex and gender differences are commonly reported in falls literature. It is critical for future research to use sex and gender terms appropriately and include similar sample sizes across all genders and sexes. In addition, there is a need to examine more gender-diverse populations and to develop interventions to prevent falls that address sex and gender differences among older adults.
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Affiliation(s)
- Crista Sebastiani
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jamie Yee Xin Wong
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Amandeep Litt
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Julia Loewen
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Karly Reece
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Conlin
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tessa Dunand
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Manuel Montero Odasso
- Schulich School of Medicine and Dentistry, Department of Medicine, Western University, London, Ontario, Canada
| | - Cassandra D'Amore
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Saunders
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Zhang T, Yang C, Shu G, Gao C, Ma H, Zou L, Zuo J, Liu S, Yan J, Hu Y. The direct and mediating effects of cognitive impairment on the occurrence of falls: a cohort study based on community-dwelling old adults. Front Med (Lausanne) 2023; 10:1190831. [PMID: 37359023 PMCID: PMC10285398 DOI: 10.3389/fmed.2023.1190831] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/18/2023] [Indexed: 06/28/2023] Open
Abstract
Background Cognitive impairment has been reported to be associated with falls in older adults. However, the complex relationship among falls, cognitive impairment and its associated factors, which could be targeted with specific interventions, remains to be elucidated. This study aimed to examine the direct effects of cognitive impairment on falls, to identify the factors associated with cognitive impairment and to explore the mediation role of cognitive impairment in the association of fall with cognition related factors. Methods This 1-year follow-up cohort study enrolled old adults aged 60 years or over. Information about demographic and anthropometric characteristics, fall outcomes, function and nutritional status were collected through face-to-face interview. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). Multivariable regression analyses were used to test the association between cognitive impairment and falls and to identify the factors related to cognitive impairment. Additionally, we conduct causal mediation analyses to estimate the mediation effects of cognitive impairment in the pathways of fall occurrence. Results Of the 569 participants included in this study, 366 (64.32%) had cognitive impairment, 96 (16.87%) had fall history in the past 1 year, 81 (14.24%) experienced fall and 47 (8.26%) received treatment because of falling during the 1-year follow-up. The association between cognitive impairment and 1-year fall risk was confirmed after adjusting for multiple covariates [odds ratio (OR):2.03, 95% confidence interval (CI): 1.13-3.80]. IADL disability, depression and low grip strength were associated with a higher prevalence of cognitive impairment. While overweight, higher education and higher income level were found to be related to a lower risk of cognitive impairment. Among these associated factors, cognitive impairment mediated the positive association of falling with IADL ability and depression, and a negative relationship with education and income level. Conclusion Our study not only confirmed the direct influence of cognitive impairment on fall risk in older adults, but also suggested a mediating role that cognitive impairment played in the pathways of fall occurrence. Our finding could help develop more specific interventions for fall prevention.
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Affiliation(s)
- Tianyi Zhang
- Institution of Hospital Management, Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing, China
| | - Cunmei Yang
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Gangming Shu
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Chang Gao
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Hongying Ma
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lin Zou
- Geriatric Health Care Department 1st of The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jing Zuo
- Geriatric Health Care Department 1st of The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shaoni Liu
- Geriatric Health Care Department 1st of The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jin Yan
- Graduate School of Chinese PLA General Hospital, Beijing, China
| | - Yixin Hu
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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Nie Z, Tracy EL, Du Y, Yang R. Depressive symptoms and falls among Chinese older adults: A bidirectional relationship. Geriatr Nurs 2023; 50:138-142. [PMID: 36780711 DOI: 10.1016/j.gerinurse.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/01/2023] [Accepted: 01/02/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND Falls and depressive symptoms are prevalent and costly. Although they are frequently interrelated, the nature of interrelationships between them was not well understood. Therefore, using longitudinal data, we aimed to explore whether there is a longitudinal bidirectional relationship between falls and depressive symptoms among older Chinese and whether this is different for men and women. METHODS Older adults aged 60 years+ who completed all 2011, 2013, 2015 waves of data from the China Health and Retirement Longitudinal Study on falls and depressive symptoms were included (N=2,203). Random intercept multilevel models were used to analyze data. RESULTS Significant bidirectional associations at between-person (b=0.09, SE=0.01, p<0.001) and within-person levels (b=0.05, SE=0.02, p=0.005) were observed between depressive symptoms and falls. When participants reported falls, they reported higher levels of depressive symptoms. However, no gender differs in these relationships. CONCLUSIONS Regardless of gender, there are significant bidirectional associations between falls and depressive symptoms.
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Affiliation(s)
- Zuoting Nie
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Eunjin Lee Tracy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Yan Du
- School of Nursing, UT Health San Antonio, San Antonio, TX, United States.
| | - Rumei Yang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.
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Tzeng HM, Raji MA, Tahashilder MI, Kuo YF. Association between medicare annual wellness visits and prevention of falls and fractures in older adults in Texas, USA. Prev Med 2022; 164:107331. [PMID: 36334680 PMCID: PMC9691561 DOI: 10.1016/j.ypmed.2022.107331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/17/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022]
Abstract
Fall-related injuries contribute to increased frailty, disability, and premature death in older adults (≥65 years). The US Centers for Medicare and Medicaid Services began reimbursing annual wellness visits (AWVs) in 2011. In the present study, we assessed the effect of AWV receipt in 2017 on fall and fracture prevention through December 31, 2018. Using Texas Medicare data for 2014-2018, we identified cohorts of Medicare beneficiaries ≥68 years, matched for the presence/absence of an AWV in 2017 by propensity score, and observed two outcomes: fracture as a primary diagnosis, and fall occurrences. Rates of each outcome were estimated using the Kaplan-Meier method. Of the 2017 beneficiaries, 32.2% received an AWV. For the 742,494 beneficiaries in the matched cohort, conditional Cox proportional hazards models revealed that receiving an AWV in 2017 was associated with reduced risks for future falls (3.9%) and fractures (4%). The effect of the AWV was stronger on fall reduction in rural residents (HR: 0.799; 95% CI: 0.679 to 0.941) and on fracture reduction in beneficiaries with ≥4 morbidities (HR: 0.918; 95% CI: 0.867 to 0.972). Receipt of an AWV in three consecutive years (2015-2017) further lowered the risk of future falls. We conclude that the risks for future falls/fractures are lower in older adults receiving AWVs. Our study underscores the need for expanded public education programs that raise awareness about AWVs and the potential for AWV data to inform fall prevention interventions and other health promotion practices.
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Affiliation(s)
- Huey-Ming Tzeng
- School of Nursing, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
| | - Mukaila A Raji
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; Department of Internal Medicine-Geriatrics and Palliative Medicine Division, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Yong-Fang Kuo
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; Department of Internal Medicine-Geriatrics and Palliative Medicine Division, University of Texas Medical Branch, Galveston, TX, USA; Office of Biostatics, University of Texas Medical Branch, Galveston, TX, USA; Department of Biostatistics and Data Science, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
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Belleville S, Cuesta M, Bieler-Aeschlimann M, Giacomino K, Widmer A, Mittaz Hager AG, Perez-Marcos D, Cardin S, Boller B, Bier N, Aubertin-Leheudre M, Bherer L, Berryman N, Agrigoroaei S, Demonet JF. Pre-frail older adults show improved cognition with StayFitLonger computerized home-based training: a randomized controlled trial. GeroScience 2022; 45:811-822. [PMID: 36266559 PMCID: PMC9589849 DOI: 10.1007/s11357-022-00674-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/12/2022] [Indexed: 02/02/2023] Open
Abstract
Multidomain interventions have shown tremendous potential for improving cognition in older adults. It is unclear if multidomain interventions can be delivered remotely and whether remote intervention is beneficial for older adults who are vulnerable or at risk of cognitive decline. In a 26-week multi-site, home-based, double-blind, randomized controlled trial, 120 cognitively healthy older adults (75 robust, 45 pre-frail; age range = 60-94) recruited from Switzerland, Canada, and Belgium were randomized to receive either the StayFitLonger (SFL) computerized multidomain training program or an active control intervention. Delivered on tablets, the SFL intervention combined adapted physical exercises (strength, balance, and mobility), cognitive training (divided attention, problem solving, and memory), opportunities for social and contributive interactions, and psychoeducation. The active control intervention provided basic mobilization exercises and access to video games. Cognitive outcomes were global cognition (Z-scores of attention, verbal fluency, and episodic memory for nondemented older adults; ZAVEN), memory, executive function, and processing speed. Linear mixed model analyses indicated improved performance on the ZAVEN global cognition score in the SFL group but not in the active control group. Stratified analyses by frailty status revealed improved ZAVEN global cognition and processing speed scores following SFL in the pre-frail group but not in the robust group. Overall, the study indicates that a computerized program providing a multidomain intervention at home can improve cognition in older adults. Importantly, pre-frail individuals, who are at higher risk of cognitive decline, seem to benefit more from the intervention. Trial registration: ClinicalTrials.gov, NCT037519 Registered on January 22, 2020-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04237519 .
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Affiliation(s)
- Sylvie Belleville
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L'Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec, H3W 1W5, Canada. .,Université de Montréal, Montreal, Canada.
| | - M. Cuesta
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada
| | - M. Bieler-Aeschlimann
- Leenaards Memory Centre and Infections Disease Service, University Hospital of Lausanne, Lausanne, Switzerland ,MindMaze, SA, Lausanne, Switzerland
| | - K. Giacomino
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | - A. Widmer
- HES-SO Valais-Wallis, School of Management, Sierre, Switzerland
| | - A. G. Mittaz Hager
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | | | | | - B. Boller
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université du Québec à Trois-Rivières, Trois-Rivieres, Canada
| | - N. Bier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université de Montréal, Montreal, Canada
| | - M. Aubertin-Leheudre
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université du Québec à Montréal, Montreal, Canada
| | - L. Bherer
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université de Montréal, Montreal, Canada ,Montréal Heart Institute, Montreal, Canada
| | - N. Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université du Québec à Montréal, Montreal, Canada
| | - S. Agrigoroaei
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - J. F. Demonet
- Leenaards Memory Centre and Infections Disease Service, University Hospital of Lausanne, Lausanne, Switzerland
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Cho IY, Kang J, Ko H, Sung E, Chung PW, Kim C. Association Between Frailty-Related Factors and Depression among Older Adults. Clin Gerontol 2022; 45:366-375. [PMID: 34346298 DOI: 10.1080/07317115.2021.1952676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We analyzed the association between individual frailty-related factors and depression in older adults. METHODS A total of 796 older adults who underwent geriatric assessments were included in this cross-sectional study. The frailty-related factors studied were grip strength, physical activity, walking speed, weight loss, and recurrent falls. Depression was based on the Geriatric Depression Scale. RESULTS After adjustment for covariates, recurrent falls were associated with depression in males (OR 3.84, 95% CI 1.30-11.35). Among females, weakest grip strength, slow walking speed, and weight loss were associated with depression (OR 2.61, 95% CI 1.52-4.49; OR 1.78, 95% CI 1.02-3.11; and OR 2.52, 95% CI 1.17-5.44, respectively). Having more frailty-related factors was also associated with higher odds of depression. CONCLUSIONS The associations between individual frailty-related factors and depression differed among males and females. Further prospective studies on depression and individual frailty-related factors by sex may help elucidate specific targets to be prioritized for clinical assessment and intervention. CLINICAL IMPLICATIONS Older adults affected by depression and frailty may present different clinical manifestations based on sex, and require different treatment approaches. Clinicians should assess both physical and psychological needs for integrated care in frail older adults.
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Affiliation(s)
- In Young Cho
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jiyoung Kang
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyeonyoung Ko
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eunju Sung
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Pil Wook Chung
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Cheolhwan Kim
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Kim S. The relationship between lifestyle risk factors and depression in Korean older adults: a moderating effect of gender. BMC Geriatr 2022; 22:24. [PMID: 34986791 PMCID: PMC8728965 DOI: 10.1186/s12877-021-02729-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/16/2021] [Indexed: 12/05/2022] Open
Abstract
Background Little is known regarding the role of gender as a possible modulator in determining the associations between lifestyle risk factors and depression in older adults. Objectives This study examined whether gender modulates the relationship between depression and lifestyle risk factors in Korean adults aged 65 years and older (n = 3700). Methods Data were obtained from the 2016 and 2018 Korea National Health and Examination Survey. The primary outcome was depression, assessed with the patient health questionnaire-9. As exposures, smoking habits, at-risk alcohol consumption, and physical inactivity were assessed with a standardized questionnaire. In addition, mean adequacy ratio (MAR) as an indicator of overall nutritional inadequacy was assessed with dietary intakes of macro- and micronutrients. Results In men only, either two or three and more risk factors were significantly associated with higher depression risk (OR (95% confidence interval, CI) = 2.886 (1.003–8.299) and OR (95% CI) = 3.109 (1.064–9.097), respectively). In women only, either two or three and more risk factors were also significantly associated with higher depression risk (OR (95% CI) = 1.505 (1.067–2.124) and OR (95% CI) = 2.828 (1.527–5.239), respectively). In particular, the presence of smoking habits and MAR were the major determinants of depression (OR (95% CI) = 1.835 (1.09–3.10) and OR (95% CI) = 1.585 (1.125–2.233), respectively) in women only. Finally, a moderation analysis with the Hayes PROCESS Macro showed a significant moderating effect of gender (β (95% CI) = 0.633 (0.206 ~ 1.060)) on the relationship between risk factors and depression. In addition, the slope of the relationship was much steeper in women than in men. Conclusion Current findings suggest that lifestyle risk factors are more closely associated with depression risk in women than in men.
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Affiliation(s)
- Shinuk Kim
- Department of Smart Information Communication Engineering, Sangmyung University, Cheonan, 330-720, South Korea.
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Lee S. Falls associated with indoor and outdoor environmental hazards among community-dwelling older adults between men and women. BMC Geriatr 2021; 21:547. [PMID: 34641812 PMCID: PMC8507100 DOI: 10.1186/s12877-021-02499-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hazardous environmental exposures are recognized risk factors for falls among older adults. However, the gender differences in the associations of falls with indoor and outdoor environmental hazards are scarce. This study examined the indoor and outdoor environmental risk factors for falls and compared the data for men and women among U.S. older adults using nationally representative data. METHODS We used the 2011 National Health and Aging Trends Study (NHATS) for a cross-sectional analysis of 6680 community-dwelling adults aged ≥65 years in the United States. A series of logistic regressions was used to identify the indoor and outdoor environmental hazards associated with falls stratified by gender after adjusting for sociodemographic, health, and behaviors. We also tested for significant interactions with gender. RESULTS Compared to men, women had a higher prevalence of falls. In the model adjusted for sociodemographic, health, and behavioral conditions, there were gender differences in the association of falls with the presence of indoor and outdoor environmental hazards. Gender-specific analyses showed that women with the presence of indoor environmental hazards (OR = 1.37, 95% CI = 1.04.-1.79) had higher odds of falls, whereas for men, the presence of outdoor environmental hazards (OR = 1.34, 95% CI = 1.02-1.75) was associated with falls. We also found a significant interaction term between outdoor environmental hazards and gender (OR = 0.65, 95% CI = 0.47-0.90). The interaction plot indicated that the presence of outdoor environmental hazards increased the risks of falling in men but not in women. CONCLUSIONS Significant gender differences exist in the association of falls with indoor and outdoor environmental hazards among older men and women. Our findings suggest that gender-tailored prevention programs to increase awareness of the environmental hazards and gender-specific environmental interventions are needed to help prevent falls.
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Affiliation(s)
- Sungmin Lee
- Department of Landscape Architecture and Urban Planning, Texas A&M University, 3137 TAMU, College Station, TX, 77840, USA.
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