Falls in older people commonly cause morbidity and mortality, loss of independence, and poor quality of life. Differences in residential environments might influence falls experienced by elderly people in urban and rural areas. The purpose of this study was to provide data through the comparative analysis of physical and environmental factors influencing falls in the frail elderly individuals in urban and rural areas, which might be used for developing the fall prevention program. A total of 534 frail elderly individuals living in regional communities were assessed over 2 months. Discomfort when walking, avoiding falls, awareness of falls, physical activity, fear of falling, depression, and a safety score for the home environment were measured. Frail elderly individuals in urban and rural areas had significant differences in terms of their prior experience of falls; the number of falls; the intake of hypertension medication, arthritis medication, and painkillers, respectively, discomfort when walking; physical activity; and the safety score of their home environments. There were significant differences between the frail elderly individuals living in urban and rural areas with the highest incidence of falls with regard to their education level, marital status, residential types, the intake of arthritis medication and painkillers, walking discomfort, physical activity, and the safety score of their home environments. In the factors influencing falls of frail elderly individuals in urban areas, stroke, visual impairment, and the fear of falling were significant explanatory variables. In the factors influencing falls of frail elderly individuals in rural areas, dizziness, walking discomfort and the fear of falling were significant explanatory variables. These results indicate that different factors influence falls among the elderly living in different residential areas.
Based on these results, a multidimensional customized fall prevention program should be considered by various factors according to residential environments to effectively prevent falls among elderly adults.