Characteristics and Risk Factors of Falls Within a Residential Environment: A Follow-Up Study of Community-Dwelling Japanese Adults Aged 75 Years and Older Requiring Long-Term Care

Introduction Understanding the characteristics of falls is crucial for effectively managing them in later life. Environmental hazards play a significant role in fall incidents with age-related life space constriction. This study explored the characteristics of falls within the home and the impact of environmental fall hazards on fall incidents among community-dwelling Japanese adults aged ≥75 years with long-term care needs. Methods This follow-up study, conducted in an outpatient day long-term care facility, enrolled 96 community-dwelling adults aged ≥75 years with long-term care needs. The occurrence and circumstances of falls within the home were recorded biweekly through face-to-face interviews during the follow-up period. Falls were categorized as "any fall" and "serious falls." Descriptive analyses were used to summarize fall characteristics. Univariate and multivariate Cox proportional hazards regression models explored the impact of environmental hazards on the time to first fall and serious falls. Results During the follow-up period, 22 participants (23.0%) had at least one fall. The most frequent fall locations were shared rooms and outdoor spaces, each accounting for approximately 30% of all reported falls. Walking was the most common activity at the time of falls (32.6%), and participants frequently attributed falls to loss of balance (46.5%). A higher number of environmental hazards significantly elevated the risk of any fall (HR: 1.15, 95% CI: 1.06-1.25, <i>p</i> < 0.05). For serious falls, environmental hazards (HR: 1.11, 95% CI: 1.00-1.23, <i>p</i> < 0.05) were significantly associated with the occurrence of serious falls within the home. Conclusions We clarified the characteristics of falls in Japanese residential environment. Assessment of environmental hazards is essential for fall prevention and management, especially within residential environments, to allow older adults to continue to live in their own homes.