Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 16;7(6):igad055.
doi: 10.1093/geroni/igad055. eCollection 2023.

Living Alone, Environmental Hazards, and Falls Among U.S. Older Adults

Haena Lee  1 , Justin H Lim  2
Affiliations

Living Alone, Environmental Hazards, and Falls Among U.S. Older Adults

Haena Lee et al. Innov Aging. .

Abstract

Background and objectives: Physical conditions of living environments can affect the incidence of falls; however, prior work has focused typically on 1 domain at a time-either neighborhood or home, capturing limited environmental boundaries of older adults. We examined how neighborhood together with the home environment affect the incidence of falls over time and whether living arrangement modifies the influence of the environmental risks on falls.

Research design and methods: Using the 2012-2020 waves of the Health and Retirement Study (HRS; N = 1,893), we fitted logistic regression to estimate the incidence of falls over an 8-year study period. We used the neighborhood and housing data that are collected systematically by trained observers in the HRS to assess environmental hazards. Sidewalk quality, neighborhood disorder, and the presence of green space were measured to capture outdoor environmental hazards. Indoor environmental hazards included the presence of housing decay and poorly maintained stairways. All models were stratified by living arrangement.

Results: Neighborhood and housing environment were independently associated with the odds of falls net of demographic characteristics and preexisting health conditions, and effects were significant for people living alone only. The presence of green space and poorly maintained stairways were associated with greater odds of falling, net of covariates during 8 years of follow-up (odds ratios = 2.10 and 2.65, p < .05, respectively). None of the environmental risk factors were significant for those living with others.

Discussion and implications: Falls in old age may be determined in part by a combination of outdoor and indoor risk factors. More research is needed to understand pathways that lead to greater vulnerability among older adults living alone to environmental hazards.

Keywords: Environment; Falls; Housing; Living alone; Neighborhood.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
Conceptual framework.
Figure 2.
Figure 2.
Predicted probabilities for the risk of falling by neighborhood measures and living arrangement, Health and Retirement Study, 2012–2020 (N = 1,893).
See this image and copyright information in PMC

References

    1. Ambrose, A. F., Paul, G., & Hausdorff, J. M. (2013). Risk factors for falls among older adults: A review of the literature. Maturitas, 75(1), 51–61. doi: 10.1016/j.maturitas.2013.02.009 - DOI - PubMed
    1. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by design and nature. Harvard University Press.
    1. Bu, F., Abell, J., Zaninotto, P., & Fancourt, D. (2020). A longitudinal analysis of loneliness, social isolation and falls amongst older people in England. Scientific Reports, 10(1), Article 1. doi: 10.1038/s41598-020-77104-z - DOI - PMC - PubMed
    1. Bugliari, D., Carroll, J., Hayden, O., Hayes, J., Hurd, M. D., Karabatakis, A., Main, R., McCullough, C. M., Meijer, E., & Moldoff, M. B. (2022). RAND HRS longitudinal file 2018 (V2) documentation: Includes 1992–2018 (final release). RAND.
    1. Caldwell, J. T., Lee, H., & Cagney, K. A. (2017). Disablement in context: Neighborhood characteristics and their association with frailty onset among older adults. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 74(7), e40–e49. doi: 10.1093/geronb/gbx123 - DOI - PMC - PubMed