Home environmental hazards and the risk of fall injury events among community-dwelling older persons

OBJECTIVE: To determine if home environmental hazards increase the risk of fall injury events among community-dwelling older persons. DESIGN: Population-based case-control study. SETTING: South Miami Beach, Florida. PARTICIPANTS: 270 persons aged 65 years and older who sought treatment at six area hospitals for injuries resulting from falls within the dwelling unit and 691 controls, frequency matched for sex and age, selected randomly from Health Care Financing Administration (Medicare) files. MAIN INDEPENDENT VARIABLES: The home environment of each person, assessed directly by interviewers using a standardized instrument. RESULTS: Environmental hazards were present in nearly all dwelling units. After adjusting for important confounding factors, most of these hazards were not associated with an increased risk of fall injury events among most older persons. Increasing numbers of tripping hazards, or total hazards in the dwelling unit, did not increase the risk of fall injury events, nor was there an increasing trend in risk. CONCLUSIONS: Current fall-prevention strategies of finding and changing all environmental hazards in all community-dwelling older persons' homes may have less potential effect than previously thought. The usefulness of grab bars, however, appears to warrant further evaluation.