Environmental and physical factors predisposing middle‐aged and older Japanese adults to falls and fall‐related fractures in the home

Aim To identify environmental and physical factors that predispose middle‐aged and older Japanese adults to falls and fall‐related fractures in the home. Methods A cross‐sectional survey was carried out in 2014. Self‐administered questionnaires were distributed to 15 000 community‐dwelling adults in Japan. The overall crude response rate was 13%. Response data were analyzed from 1561 individuals aged ≥40 years using multiple imputation to analyze missing data. We evaluated falls without fractures and fall‐related fractures during the previous 3 years according to demographic, physical and environmental factors, including age, sex, long‐term care insurance certification, type of house and barrier‐free housing. Results Of the 1561 adults (mean age 68.1 ± 13.0 years), 28% experienced a fall in the home. Among the individuals who experienced a fall, 11% experienced fall‐related fractures. These individuals were more likely to be women (OR 2.4, 95.0% CI 1.1–5.1), have LTCI certification (OR 3.9, 95.0% CI 1.6–9.4) and be living in a barrier home (OR 4.0, 95.0% CI 1.6–9.8), after adjustment for covariates. Conclusions Environmental factors, such as living in a barrier home, are critical for fall‐related fractures, in addition to demographic and physical factors. A multidisciplinary approach that considers both physical and environmental factors is necessary for reducing the incidence of fall‐related fractures among middle‐aged and older Japanese adults. Geriatr Gerontol Int 2018; 18: 1372–1377 .