A scoping review: domestic fall risks in older adults stemming from unsafe behaviors and their association with physical environmental factors

Abstract Aim Although the physical environment is frequently studied in the context of domestic accidents, behavioral factors, particularly individual and interpersonal behavior, have received less attention. This scoping review aimed to address two research questions: 1) What social environmental factors are most relevant for fall risk assessments in home-dwelling older adults? 2) How do physical environmental factors influence individual and interpersonal behaviors that increase domestic fall risk? Method The review followed the PRISMA-ScR guidelines, and the search was conducted in April 2022 across multiple databases, including MEDLINE, CINAHL, Nursing & Allied Health, Applied Social Sciences Index & Abstracts (ASSIA), Sage, ScienceDirect, Social Science Premium Collection, Scopus, and Web of Science. A total of 44 peer-reviewed studies reporting on domestic fall risk factors for older adults living at home were included. Results Findings indicate that both inattentive and attentive individual behaviors can increase fall risk. In terms of interpersonal behavior, social interaction and connectedness were highlighted as critical contributors to overall fall risk. Additionally, health-related factors were found to associate with environmental risk factors. Conclusion The study proposes a theoretical fall risk framework compassing individual factors, interpersonal behavior, and physical environmental factors. Specific physical environmental factors can trigger unsafe behaviors that elevate fall risks among older adults, particularly those with existing health conditions. Both social and physical environmental factors should be a key focus in fall prevention strategies.