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.