Perceived neighborhood and fall history among community-dwelling older adults living in a large Brazilian urban area: a multilevel approach

ABSTRACT

Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14–5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.

KEYWORDS:

• Falls
• aged
• urban health
• neighborhood
• multilevel analysis

Acknowledgments

The authors thank all researchers of the Observatory for Urban Health in Belo Horizonte (OSUBH) that participated in the BH Health Study. The Coordination of Improvement of Higher Education Personnel (CAPES) for a post-doctoral scholarship to the researcher BSM and the National Council of Scientific and Technological Development (CNPq) for a research productivity scholarship to the researchers AALF and WTC.

Disclosure of interest

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the National Health Fund of the Ministry of Health under [Grant number 162/2006]; CNPq under [Grant number 47504/2006-0]; Fapemig under [Grant number APQ-00975-08]; NIH/Fogarty International Center under [Grant number 1R03TY008105-01]. The funders had no role in study design, data collection and analysis, decision to publish the results or preparation of the manuscript.