Falls and the Physical Environment: A Review and a New Multifactorial Falls-Risk Conceptual Framework

Abstract

Background. Fall-related injuries result in significant physical and psychological suffering to the affected individuals. The physical environment is considered to have an important role in falls. Purpose. To conduct extensive review of and synthesize related literature, and to develop a conceptual framework to explain the relationship among falls, the physical environment, and older adults. Method. Review of the literature was conducted to examine: (a) link between environmental hazards and falls, (b) efficacy of home-modification interventions, and (c) role of the physical environment in falls of people with cognitive impairment. Results. A strong link between environmental hazards and the risk of falls has yet to be established. A conceptual framework is presented that proposes that an individual's risk for falls can be determined by the interaction of three main factors: mobility, risk-taking behaviour, and physical environment. Implications. Environmental interventions should be combined with other interventions such as exercise programs and education.