Photo: Texas A&M Health Science Center

Female residents of larger residential care facilities who need assistance with at least one activity of daily living are at the highest risk of falling compared with other residents, a new analysis of national data reveals.

The study, published in the Journal of Aging and Health, also found that white or Caucasian residents of residential care facilities, including assisted living communities, had the highest rate of falls leading to injury, at 15.5%, compared with all other racial groups. Asian adults had a rate of 11%, and black or African-American adults had a rate of 5.5%.

“It’s not something that was surprising nationally,” said lead author Samuel D. Towne Jr., Ph.D., of the Texas A&M Health Science Center School of Public Health. “When you start to think of falls or fall-related hospitalizations, it is a common finding that white or Caucasian older adults, in particular women, do suffer a large proportion of falls. More research is needed on that.”

Towne and his coauthors crunched numbers from the Centers for Disease Control and Prevention and its National Center for Health Statistics and also discovered that the fall rate was almost 16% at large or extra-large communities (those with 26 to more than 100 beds) compared with 11% at small or medium communities (those with four to 25 beds), for reasons that are unclear.

Because more than 700,000 adults live in residential care facilities nationally, Towne said, the research shows that more than 100,000 residents may experience falls resulting in injury every year.

“The fact that we found approximately 15% of people in these facilities suffering an injurious fall is a serious issue, and it is a story that needed to be told,” he said. “The 15% who fell doesn’t even account for falls that were not reported or falls that didn’t lead to injury.”

Residential care facilities can learn lessons from aging-in-place efforts in the greater community, where falls prevention programs focus on addressing environmental aspects by, for instance, installing grab bars in bathrooms and ensuring lighting in restrooms, Towne said. Different settings may require different approaches, however, he added.

The CDC’s definition of residential care facilities includes not only assisted living communities but also board-and-care homes, congregate care, enriched housing programs, homes for the aged, personal care homes and shared housing establishments that are licensed, registered, listed, certified or otherwise regulated by a state.