Housing quality and related housing environmental factors associated with falls in older adults: results from the longitudinal ageing study in India.

Falls are a significant cause of morbidity, disability, and mortality amongst older adults worldwide, with approximately one-third of Indian older adults experiencing falls annually. Despite extensive research on individual-level risk factors, the relationship between housing quality and fall risk remains understudied. This study examined the relationship between housing quality and falls. We analysed data from 30 632 adults aged ≥60 years from the longitudinal ageing study in India (2017-2018). Housing quality was assessed using five indicators (housing materials, sanitation, water access, cooking fuel, electricity) categorised as good (scores 0-1), moderate (scores 2-3), or poor (scores 4-5). Related environmental factors included lack of separate bedrooms/kitchens, indoor air pollutants, and household dampness. Self-reported falls >2 years were analysed using generalised linear mixed models with adjustment for sociodemographic, health, and lifestyle factors. Participants had a median age of 67 years (interquartile range: 63, 73) with 52.0% female. After full adjustment, the housing quality index showed significant association with falls [odds ratio (OR) = 1.17, 95% confidence interval (CI): 1.13-1.21 per unit increase, P < .001]. Compared to good housing quality, moderate (OR = 1.32, 95% CI: 1.20-1.45) and poor (OR = 1.76, 95% CI: 1.56-1.98) housing quality were associated with a higher fall risk. Four housing quality indicators (poor sanitation, inadequate water access, solid fuel use, lack of electricity) and related housing environment factors (lack of separate bedrooms/kitchen, indoor air pollutants, household dampness) were all independently associated with increased fall risk. Poor housing quality significantly increases fall risk in older Indians, suggesting housing interventions may be effective fall prevention strategies.