Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
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Environmental Factors Influencing the Prevalence of Falls in South Korea

  • Kim, Beomryong (Department of Physical Therapy, Design Hospital) ;
  • Do, Kwangsun (Catholic Kwandong University International St. Mary's Hospital) ;
  • Yim, Jongeun (Department of Physical Therapy, Graduate School of Sahmyook University)
  • Received : 2022.02.23
  • Accepted : 2022.03.21
  • Published : 2022.03.31
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Abstract

Objective: This study is a systematic review conducted to analyze the environmental factors that cause falls in the older adult. Design: Systematic review Methods: The study was conducted by searching the Research Information Sharing Service (RISS), Korean studies Information Service System (KISS), and Data Base Periodical Information Academic (DBpia) databases for literature published in South Korea up to July 2020. A total of 12 studies were selected for analysis based on the inclusion and exclusion criteria. Results: The results of the analysis revealed that all the selected literature were surveys and the study subjects were 65 years of age and above. The sample size ranged from a minimum of 95 subjects to a maximum of 3,278. A total of eight tools were used to measure the environmental factors associated with falls. The prevalence and recurrence of falls increase with age and deterioration of health. Older adult individuals who experience falls encounter difficulties in recovering from impaired physical function and disability; moreover, in severe cases, falls may lead to death. Falls are largely associated with a combination of intrinsic and extrinsic (i.e., environmental) factors. The purpose of this study was to assess potential extrinsic risk factors for falls. Falls occur in indoor environments, such as washrooms, bathrooms and living rooms, and outdoor environments, including roads and stairways, depending on the season, time of day, and use of ambulatory aids. In such environments, falls are mainly caused by slipping and stuttering. Conclusions: Therefore, as the rate of fall is influenced by several factors, extrinsic factors should be improved by developing comprehensive accident prevention programs that address the improvement of environmental risk factors around places of residence to reduce risk factors among the older adult, who, especially, are at a high risk for falls.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (No. NRF-2020R1A2C1103035).

References

  1. Dionyssiotis Y. Analyzing the problem of falls among older people. Int J Gen Med. 2012;5:805-813. https://doi.org/10.2147/IJGM.S32651
  2. Rubenstein LZ, Josephson KR. Falls and their prevention in elderly people: what does the evidence show? Med Clin. 2006;90:807-824.
  3. Malasana G, Brignole M, Daccarett M, Sherwood R, Hamdan MH. The prevalence and cost of the faint and fall problem in the state of Utah. Pacing Clin Electrophysiol. 2011;34:278-283. https://doi.org/10.1111/j.1540-8159.2010.02930.x
  4. Blake AJ, Morgan K, Bendall MJ, Dallosso H, Ebrahim SB, Arie TH, et al. Falls by elderly people at home: prevalence and associated factors. Age Ageing. 1988;17:365-372. https://doi.org/10.1093/ageing/17.6.365
  5. Prudham D, Evans JG. Factors associated with falls in the elderly: a community study. Age Ageing. 1981;10:141-146. https://doi.org/10.1093/ageing/10.3.141
  6. WHO. WHO global report on falls prevention in older age. Geneva:World Health Organization; 2008.
  7. Ryeom TH, Kim ST, So YK, Park SY, Lee JH, Cho HS, et al. The risk factors of falls in the elderly. J Korean Acad Fam Med. 2001;22:221-229.
  8. Tinetti ME, Kumar C. The patient who falls: "It's always a trade-off". JAMA. 2010;303:258-266. https://doi.org/10.1001/jama.2009.2024
  9. Tzeng HM, Yin CY.The extrinsic risk factors for inpatient falls in hospital patient rooms. J Nurs Care Qual. 2008;23:233-241. https://doi.org/10.1097/01.NCQ.0000324588.91837.84
  10. Campbell AJ, Reinken J, Allan BC, Martinez GS. Falls in old age: a study of frequency and related clinical factors. Age Ageing. 1981;10:264-270. https://doi.org/10.1093/ageing/10.4.264
  11. Masud T, Morris RO. Epidemiology of falls. Age Ageing. 2001;30:3-7. https://doi.org/10.1093/ageing/30.suppl_4.3
  12. Yoo IY, Choi JH. Experience of falls and predictors of falls in the elderly at senior citizens' centers. J Korean Acad Comm Health Nurs. 2007;18:14-22.
  13. Fonda D, Cook J, Sandler V, Bailey M. Sustained reduction in serious fall-related injuries in older people in hospital. Med J Aus. 2006;184:379-382. https://doi.org/10.5694/j.1326-5377.2006.tb00286.x
  14. Lord SR, Menz HB, Sherrington C. Home environment risk factors for falls in older people and the efficacy of home modifications. Age Ageing. 2006;35:ii55-ii59. https://doi.org/10.1093/ageing/afl088
  15. Choi KW, Lee IS. Fall risk in low-income elderly people in one urban area. J Korean Acad Nurs. 2010;40:589-598. https://doi.org/10.4040/jkan.2010.40.4.589
  16. Park YH, Moon JS. Home environmental hazards of falling accident in the elderly. Korean J Health Education and Promotion. 2005;22:203-213.
  17. Chase CA, Mann K, Wasek S, Arbesman M. Systematic review of the effect of home modification and fall prevention programs on falls and the performance of community-dwelling older adults. Am J Occup Ther. 2012;66:284-291. https://doi.org/10.5014/ajot.2012.005017
  18. Stark S, Keglovits M, Arbesman M, Lieberman D. Effect of home modification interventions on the participation of community-dwelling adults with health conditions: a systematic review. Am J Occup Ther. 2017;71:7102290010p1-7102290010p11. https://doi.org/10.5014/ajot.2017.018887
  19. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336-341. https://doi.org/10.1016/j.ijsu.2010.02.007
  20. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. MNECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National evidence-based healthcare collaborating agency; 2011.
  21. Arbesman M, Scheer J, Lieberman D. Using AOTA's critically appraised topic (cat) and critically appraised paper (cap) series to link evidence to practice. OT practice. 2008;13:18-22.
  22. Lee CM, Cho BH. Fall risk in the community- dwelling elderly who received home care services: focused on residential environment and perception of fall risk. J Muscle Joint Health. 2014;21:36-45. https://doi.org/10.5953/JMJH.2014.21.1.36
  23. Cho YC, Yoon HS. Falls among community dwelling elderly people: prevalence and associated factors. J Agric Med Community Health. 2004;29:223-235.
  24. Kim SM. The comparison of risk factors for falls in the community-dwelling elderly. PNF & Mov. 2016;14:93-103.
  25. Gill TM, Robison JT, Williams CS, Tinetti ME. Mismatches between the home environment and physical capabilities among community-living older persons. J Am Geriatr Soc. 1999;47:88-92. https://doi.org/10.1111/j.1532-5415.1999.tb01906.x
  26. Park H, Shroyer J.The relationship between environmental design factors and perception of falls risk by older people and design recommendations for reducing falls risks at home. Korean Home Econ Assoc. 1996;34:45-55.
  27. Park Y. Fall risk assessment in the communitydwelling elderly. J Korean Gerontol Nurs. 2004;6:170-178.
  28. Jang I, Kim S. A study on risk factors of injuries from fall experienced by home-staying elders in a provincial area. J Korean Gerontological Nurs. 2006;8:107-116.
  29. Hwang ON. A survey study on the factors associated with falls among elderly. J Korean Acad Adult Nurs. 1998;10:337-352.
  30. Paek K, Song H, Cho J. Effectiveness of bathroom grab bar to prevent falls in elderly. J Korean Gerontol Soc. 2002;22:85-98.
  31. Kim M. Associated factors caused by falls of older people in community-dwelling. Unpublished master's thesis: Ewha Womans University. Seoul; 2004.
  32. Sattin RW, Rodriguez JG, DeVito CA, Wingo PA. Home environmental hazards and the risk of fall injury events among community-dwelling older persons. J Am Geriatr Soc. 1998;46:669-676. https://doi.org/10.1111/j.1532-5415.1998.tb03799.x
  33. Huang HC, Gau ML, Lin WC, George K. Assessing risk of falling in older adults. Public Health Nurs. 2003;20:399-411. https://doi.org/10.1046/j.1525-1446.2003.20508.x
  34. Stevens M, Holman CDAJ, Bennett N. Preventing falls in older people: impact of an intervention to reduce environmental hazards in the home. J Am Geriatr Soc. 2001;49:1442-1447. https://doi.org/10.1046/j.1532-5415.2001.4911235.x
  35. Yoo I. Fall and housing environmental problem of the couple and single elderly. J Korean Soc Living Sys. 2005;12:199-205.
  36. Kim MC, Cho H, Sunwoo S, Kim SW, Cho HJ. Prevalence and associated factors of fall among the elderly in nursing home. J Korean Geriatr Soc. 1999;3:29-38.
  37. Jang I, Kim D. Home safety assessment for fall prevention in elderly people in a rural community. J Korean Gerontological Nurs. 2002;4:176-186.
  38. Yoo IY. Analysis of multi-variate recurrent fall risk factors in elderly people using residential assessment instrument-home care-comparisons between single and recurrent fallers. J Korean Acad Nurs. 2011;41:119-128. https://doi.org/10.4040/jkan.2011.41.1.119
  39. Kim JM, Suh HK. Risk factors for falls in the elderly by life-cycle. Korean J Health Educ Prom. 2010;27:21-34.
  40. Eom J. A study on the elderly patients hospitalized due to fall injuries. Unpublished master's thesis: Ewha Womans University. Seoul; 2006.
  41. Kim D. Prevalence and associated factors of falls in the elderly in a rural community. Unpublished master's thesis: Seoul National University. Seoul;2002.
  42. Park AJ, Lim NY, Kim YS, Lee YK, Song YS. Incidence and predictors of falls in institutionalized elderly. J Musc Joint Health. 2011;18:50-62. https://doi.org/10.5953/JMJH.2011.18.1.050
  43. Yoo I, Lee J. Characteristics and factors associated with falls of the community-dwelling elderly in small cities. J Korean Soc Living Environ Syst. 2009;16:428-435.
  44. Lee JE, Do WH. A study of elementary school students' feet growth by 3D scan data. Fashion Textile Res J. 2014;16:935-944. https://doi.org/10.5805/SFTI.2014.16.6.935
  45. Pynoos J, Steinman BA, Nguyen, AQ. Environmental assessment and modification as fall-prevention strategies for older adults. Clin Geriatr Med. 2010;26:633-644. https://doi.org/10.1016/j.cger.2010.07.001
  46. Chai K. A literature review a program of intervention for prevention of falling in the patients with dementia. J Occupational Ther Aged Dementia. 2010;4:27-34.
  47. Iwarsson S, Horstmann V, Carlsson G, Oswald F, Wahl HW. Person-environment fit predicts falls in older adults better than the consideration of environmental hazards only. Clin Rehabil. 2009;23:558-567. https://doi.org/10.1177/0269215508101740
  48. French DD, Werner DC, Campbell RR, Powell-Cope GM, Nelson AL, Rubenstein LZ, et al. A multivariate all risk assessment model for VHA nursing homes using the minimum data set. J Am Med Dir Assoc. 2007;8:115-122. https://doi.org/10.1016/j.jamda.2006.08.005
  49. Kim JM, Lee MS, Song HJ. An analysis of risk factors for falls in the elderly by gender. Korean J Health Educ Prom. 2008;25:1-18.
  50. Stevens JA. Falls among older adults-risk factors and prevention strategies. J Safety Res. 2005;36:409-411. https://doi.org/10.1016/j.jsr.2005.08.001
  51. Jo HS, Kim CB, Lee HW, Jeong HJ. A meta-analysis of health related behavior study based on health belief model in Korean. Korean J Health Psychol. 2004;9:69-84.
  52. Stevens JA, Mahoney JE, Ehrenreich H. Circumstances and outcomes of falls among high risk community-dwelling older adults. Inj Epidemiol. 2014;1:1-9. https://doi.org/10.1186/2197-1714-1-1
  53. Braun BL. Knowledge and perception of fall-related risk factors and fall-reduction techniques among community-dwelling elderly individuals. Phy Ther. 1998;78:1262-1276. https://doi.org/10.1093/ptj/78.12.1262
  54. Hughes K, Van Beurden E, Eakin EG, Barnett LM, Patterson E, Backhouse J, et al. Older persons' perception of risk of falling: implications for fall-prevention campaigns. Am J Public Health. 2008;98:351-357. https://doi.org/10.2105/AJPH.2007.115055
  55. Yardley L, Donovan-Hall M, Francis K, Todd C. Older people's views of advice about falls prevention: a qualitative study. Health Educ Res. 2006;21:508-517. https://doi.org/10.1093/her/cyh077
  56. Aminzadeh F,Edwards N. Factors associated with cane use among community dwelling older adults. Public Health Nurs. 2000;17:474-483. https://doi.org/10.1046/j.1525-1446.2000.00474.x
  57. Wyman JF, Croghan CF, Nachreiner NM, Gross CR, Stock HH, Talley K, et al. Effectiveness of education and individualized counseling in reducing environmental hazards in the homes of communitydwelling older women. J Am Geriatr Soc. 2007;55:1548-1556. https://doi.org/10.1111/j.1532-5415.2007.01315.x
  58. Summary of the Updated American Geriatrics Society. British geriatrics society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148-157. https://doi.org/10.1111/j.1532-5415.2010.03234.x
  59. Nikolaus T, Bach M. Preventing falls in community -dwelling frail older people using a home intervention team (HIT): results from the randomized Falls-HIT trial. J Am Geriatr Soc. 2003;51:300-305. https://doi.org/10.1046/j.1532-5415.2003.51102.x
  60. Lim K, June K, Yoon J. The comparison of health status, functional status, and home environment hazards in terms of the fear of falling in community- dwelling older adults. J Korea Gerontol Soc. 2009;29:1577-89.
  61. Tideiksaar R. Falling in old age: prevention and management. Springer Publishing Company; 1996.
  62. Josephson KR, Fabacher DA, Rubenstein LZ. Home safety and fall prevention. Clin Geriatr Med. 1991;7:707-732. https://doi.org/10.1016/s0749-0690(18)30515-9
  63. Park E, Jang I. Development of the home fall prevention checklist for community-dwelling older adults. J Korea Contents Association. 2013;13:354-365. https://doi.org/10.5392/JKCA.2013.13.05.354