Falls in Older Adults: A Systematic Review of Literature on Interior-Scale Elements of the Built Environment

Falls are the leading causes of injury and injury-related deaths in older adults. This review examined the role of interior-scale elements of living environments, including homes, nursing homes, retirement facilities, care facilities, and assisted living facilities, on falls among elderly residents. A comprehensive review of empirical studies, published in peer-reviewed journals, was conducted using the PRISMA process. Results revealed that while several environmental elements are identified as risk factors, a few are fully examined. Flooring is the most examined element in terms of number and robustness of research. Studies that assessed bundled interventions support the notion that environmental attributes affect the incidence and severity of falls. There is a need for more causal and correlational studies to determine the specific impact of each environmental element on falls to inform facility design decisions.