Sex differences in circumstances and consequences of outdoor and indoor falls in older adults in the MOBILIZE Boston cohort study

Duckham, Rachel L; Procter-Gray, Elizabeth; Hannan, Marian T; Leveille, Suzanne G; Lipsitz, Lewis A; Li, Wenjun

doi:10.1186/1471-2318-13-133

Table 2 Place and activity-specific numbers, rates and women/men rate ratios (95% Confidence Intervals) of falls and injurious falls by sex (per 1,000 person-years)

From: Sex differences in circumstances and consequences of outdoor and indoor falls in older adults in the MOBILIZE Boston cohort study

			All falls					Falls resulting in injury
	Number of falls^#	Men’s rate	Women’s rate	Crude rate ratio	Adjusted†	Number of falls^#	Men’s rate	Women’s rate	Crude rate ratio	Adjusted†
				(Women/Men)	Rate ratio				(Women/Men)	Rate ratio
				(Women/Men)	(Women/Men)				(Women/Men)	(Women/Men)
Total falls	1680	915	779	0.85 (0.70 - 1.04)	1.01 (0.84 - 1.21)	715	281	385	1.37 (1.09 - 1.70)**	1.45 (1.17 - 1.80)**
Total outdoor falls	786	461	330	0.72 (0.56 - 0.92)**	0.84 (0.67 - 1.05)	364	174	176	1.01 (0.77 - 1.33)	1.15 (0.88 - 1.51)
I. Place of outdoor fall
In own neighborhood (6 blocks)	432	247	182	0.74 (0.56 - 0.98)*	0.84 (0.65 - 1.10)	199	88	100	1.14 (0.81 - 1.60)	1.31 (0.94 - 1.84)
Out of neighborhood ( > 6 blocks)	346	211	144	0.68 (0.48 - 0.96)*	0.85 (0.62 - 1.16)	161	83	75	0.90 (0.62 - 1.29)	1.04 (0.73 - 1.49)
Specific location,
Sidewalk, street, curb	323	152	156	1.03 (0.75 - 1.41)	1.28 (0.94 - 1.73)	178	70	95	1.35 (0.92 - 1.97)	1.66 (1.14 - 2.43)**
Just outside private home	220	134	87	0.65 (0.45 - 0.93)*	0.74 (0.52 - 1.05)	97	49	45	0.93 (0.59 - 1.47)	1.04 (0.65 - 1.66)
Recreational	117	104	36	0.34 (0.17 - 0.70)**	0.30 (0.15 - 0.58)**	28	22	10	0.43 (0.15 - 1.20)	0.39 (0.14 - 1.10)
Parking place	91	53	39	0.73 (0.45 - 1.18)	0.79 (0.48 - 1.28)	47	25	21	0.86 (0.47 - 1.59)	0.92 (0.49 - 1.71)
Public transit	31	20	11	0.55 (0.19 - 1.59)	1.21 (0.40 - 3.65)	12	08	NC	0.54 (0.14 - 2.07)	0.76 (0.20 - 2.83)
II. Activity at time of outdoor fall
Walking	356	190	158	0.83 (0.61 - 1.13)	0.98 (0.74 - 1.30)	165	72	83	1.15 (0.80 - 1.66)	1.42 (1.00 - 2.02)
Vigorous activity	109	92	35	0.38 (0.18 - 0.81)*	0.42 (0.21 - 0.84)*	32	24	11	0.45 (0.18 - 1.11)	0.51 (0.20 - 1.27)
Going up or down stairs	107	55	49	0.90 (0.56 - 1.42)	1.01 (0.63 - 1.61)	63	30	31	1.00 (0.57 - 1.76)	1.09 (0.62 - 1.93)
Single step/curb	50	25	24	0.94 (0.51 - 1.73)	1.07 (0.57 - 2.00)	29	13	15	1.10 (0.51 - 2.38)	1.16 (0.53 - 2.56)
Gardening/lawn care	47	28	18	0.67 (0.32 - 1.38)	0.94 (0.44 - 1.98)	14	NC	09	3.41 (0.71 - 16.42)	4.28 (0.87 - 21.02)
Getting in/out of something	28	17	11	0.67 (0.31 - 1.43)	0.66 (0.30 - 1.43)	13	08	05	0.67 (0.23 - 2.01)	0.54 (0.17 - 1.72)
Not moving	21	13	08	0.63 (0.25 - 1.59)	0.77 (0.31 - 1.90)	11	NC	06	1.53 (0.37 - 6.26)	1.93 (0.47 - 7.85)
Bending	15	11	05	0.50 (0.16 - 1.58)	0.44 (0.13 - 1.53)	7	04	NC	0.77 (0.17 - 3.44)	0.72 (0.14 - 3.59)
Other	37	20	17	0.84 (0.42 - 1.69)	1.09 (0.54 - 2.19)	24	10	12	1.16 (0.49 - 2.75)	1.63 (0.67 - 3.98)
III. Outdoor environment
Surface conditions
Dry	494	259	221	0.86 (0.65 - 1.12)	1.01 (0.79 - 1.30)	275	129	134	1.04 (0.76 - 1.41)	1.17 (0.87 - 1.58)
Snowy/icy	199	140	77	0.55 (0.36 - 0.86)**	0.57 (0.38 - 0.87)**	54	24	28	1.16 (0.63 - 2.12)	1.34 (0.73 - 2.43)
Wet	71	43	28	0.65 (0.36 - 1.16)	0.86 (0.47 - 1.55)	32	18	14	0.74 (0.35 - 1.56)	0.92 (0.42 - 2.03)
Slipped or tripped	518	291	223	0.77 (0.58 - 1.02)	0.85 (0.66 - 1.11)	231	101	117	1.17 (0.83 - 1.64)	1.30 (0.94 - 1.81)
Poor lighting	49	22	25	1.15 (0.57 - 2.32)	1.30 (0.65 - 2.60)	24	NC	14	1.73 (0.65 - 4.61)	1.93 (0.72 - 5.12)
Total indoor falls	894	428	446	1.05 (0.82 - 1.34)	1.18 (0.94 - 1.48)	351	107	209	1.98 (1.44 - 2.72)**	1.96 (1.44 - 2.68)**
I. Place of indoor fall
In own home	726	355	363	1.03 (0.79 - 1.35)	1.20 (0.93 - 1.54)	263	86	155	1.84 (1.30 - 2.59)**	1.84 (1.31 - 2.58)**
Living/family room	183	96	88	0.93 (0.62 - 1.39)	1.03 (0.70 - 1.52)	48	23	27	1.44 (0.70 - 2.97)	1.42 (0.70 - 2.85)
Bedroom	156	59	85	1.44 (0.91 - 2.28)	1.55 (0.98 - 2.46)	64	20	38	1.90 (0.99 - 3.64)	1.89 (0.97 - 3.68)
Stairs in home	99	66	37	0.57 (0.34 - 0.95)*	0.51 (0.30 - 0.86)*	38	13	21	1.61 (0.76 - 3.41)	1.53 (0.72 - 3.22)
In home, other/don’t know	95	60	40	0.68 (0.35 - 1.31)	0.94 (0.49 - 1.81)	19	11	09	0.96 (0.36 - 2.57)	0.92 (0.34 - 2.47)
Kitchen/dining room	87	29	51	1.88 (1.04 - 3.40)*	2.72 (1.42 - 5.22)**	39	04	27	6.83 (2.05 - 22.79)**	6.37 (1.91 - 21.26)**
Hall/lobby/doorway	60	24	33	1.37 (0.73 - 2.57)	1.37 (0.73 - 2.57)	29	09	17	1.82 (0.75 - 4.44)	1.78 (0.72 - 4.36)
Bathroom	46	16	26	1.63 (0.79 - 3.37)	2.09 (0.94 - 4.63)	26	08	15	1.92 (0.74 - 5.00)	3.45 (1.01 - 11.73)*
In another home	37	12	21	1.80 (0.84 - 3.87)	1.73 (0.81 - 3.71)	18	03	12	4.65 (1.05 - 20.66)*	4.43 (1.00 - 19.60)
Inside another building	131	62	63	1.02 (0.66 - 1.57)	1.02 (0.66 - 1.58)	70	19	42	2.29 (1.18 - 4.44)*	2.23 (1.13 - 4.40)*
II. Activity at time of indoor fall
Walking	324	147	172	1.20 (0.84 - 1.70)	1.46 (1.04 - 2.06)*	129	32	82	2.47 (1.50 - 4.06)**	2.51 (1.52 - 4.16)**
Vigorous activity	34	NC	20	1.78 (0.74 - 4.31)	1.78 (0.71 - 4.44)	13	04	08	1.88 (0.49 - 7.27)	1.73 (0.44 - 6.74)
Going up or down stairs	132	81	53	0.66 (0.43 - 1.02)	0.63 (0.40 - 0.97)*	59	21	33	1.55 (0.85 - 2.82)	1.48 (0.82 - 2.69)
Single step/curb	4	02	02	0.61 (0.05 - 7.12)	1.03 (0.05 - 19.37)	0	0	0	--	--
Household tasks	44	08	29	3.68 (1.50 - 8.98)**	3.48 (1.41 - 8.55)**	19	03	13	4.91 (1.13 - 21.26)**	NC
Getting in/out of something	135	55	70	1.29 (0.81 - 2.04)	1.51 (0.94 - 2.41)	55	16	33	2.04 (1.02 - 4.08)*	2.59 (1.21 - 5.56)*
Not moving	94	49	45	0.93 (0.55 - 1.57)	0.95 (0.57 - 1.57)	35	14	19	1.42 (0.64 - 3.18)	1.30 (0.59 - 2.90)
Bending	35	17	17	0.95 (0.43 - 2.10)	0.92 (0.40 - 2.10)	15	05	08	1.52 (0.40 - 5.76)	1.32 (0.34 - 5.12)
Other	68	31	34	1.09 (0.59 - 2.00)	1.09 (0.59 - 2.03)	26	08	15	1.86 (0.69 - 4.98)	1.73 (0.64 - 4.69)
III. Indoor environment
Surface conditions
Dry	858	408	431	1.06 (0.82 - 1.37)	1.20 (0.95 - 1.51)	334	102	200	2.01 (1.45 - 2.79)**	1.98 (1.44 - 2.74)**
Wet	31	17	14	0.80 (0.39 - 1.64)	0.82 (0.40 - 1.71)	15	07	08	1.16 (0.38 - 3.59)	1.38 (0.40 - 4.69)
Slipped or tripped	384	157	203	1.29 (0.96 - 1.74)	1.32 (0.99 - 1.75)	159	41	97	2.35 (1.54 - 3.59)**	2.34 (1.54 - 3.57)**
Light conditions too poor to see	69	24	39	1.63 (0.92 - 2.87)	1.56 (0.89 - 2.76)	36	07	NC	NC	NC

Sample population 267 men and 467 women with a total of 1680 falls with indoor/outdoor location information, and a total follow-up time of 2066.5 person years.
All rates and rate ratios estimated by negative binomial regression.
Abbreviations: RR Rate Ratio, ratio of women rate to men rate. NC Regression model does not converge (too few observations).
^#Number of falls for men and women combined. *p-value <0.05 **p-value <0.01.
†Adjusted for a risk score composite of all factors in Table 1: age, education, race, body mass index, physical activity, blocks walked per week, outdoor walking type, balance, chair-stand ability, gait speed, activities of daily living, short physical performance battery, reduced activity due to illness in past year, poor vision, bodily pain, number of comorbidities, self-rated health, peripheral neuropathy, foot pain, knee osteoarthritis, depression, number of medications, use of psychotropic medication, MMSE, Trails-B score, number of falls in year before baseline and falls efficacy.

Back to article page

ISSN: 1471-2318

Contact us

Submission enquiries: bmcgeriatrics@biomedcentral.com
General enquiries: ORSupport@springernature.com

BMC Geriatrics

Contact us