Exploring the Influence of the Perceived Neighborhood Built Environment on the Fall Risks among Older Adults in China

Falls are the leading cause of accidental injury-related deaths among older adults, with approximately 50% of them occurring in the neighborhood built environment. This longitudinal study investigated the influence of the perceived built environment (PBE) on fall risks among Chinese older adults residing in neighborhoods. We utilized data from the 2018 and 2020 waves of the China Longitudinal Aging Social Survey (CLASS), comprising a sample size of 8686 respondents. A complementary log–log (cloglog) regression was used to effectively model falls because of their infrequent occurrence. The results revealed a significant U-shaped non-linear relationship between PBE and falls. As the PBE score increased from relatively low levels, there was a decrease in the probability of falls, indicating that enhancing PBE can effectively protect against fall risks. However, once an average PBE score threshold was reached (around a turning point score of 22), this association may slightly reverse. Living alone and living in urban areas are two major factors that increase the vulnerability of older adults to PBE, resulting in higher fall risks within their neighborhoods. The study enhances the understanding of how PBE affects fall risks among older adults.