Bathroom modifications among community-dwelling older adults who experience falls in the United States: A cross-sectional study

Health Soc Care Community. 2022 Jan;30(1):253-263. doi: 10.1111/hsc.13398. Epub 2021 Apr 24.


Falls impose substantial health and economic burdens on older adults. Over half of falls in older adults occur at home, with many involving bathroom areas. Limited information is available on the presence of bathroom modifications for those who experience them. Therefore, we examined factors associated with bathroom modifications among older adults with at least one fall in the United States. We analysed the nationally representative 2016 Medicare Current Beneficiary Survey Public Use File of Medicare beneficiaries aged ≥65 years with ≥1 fall (n = 2,404). A survey-weighted logistic model was used to examine associations between bathroom modifications and factors including socio-demographic characteristics, health-related conditions, and fear of falling. Among Medicare beneficiaries with ≥1 fall, 55.5% had bathroom modifications and 50.1% had repeated falls (≥2 falls). Approximately 40.2% of those with repeated falls had no bathroom modifications. In the adjusted model, non-Hispanic Blacks (odds ratio [OR] = 0.38; p < 0.001) and Hispanics (OR = 0.64; p = 0.039) had lower odds of having bathroom modifications than non-Hispanic Whites. Fear of falling and activities of daily living limitations had incremental impacts on having bathroom modifications. This study highlights the need to improve disparities in bathroom modifications for non-Hispanic Black and Hispanic Medicare beneficiaries, including those with repeated falls. With the aging population and growing number of older minorities in the United States, reducing these disparities is vital for fall prevention efforts and aging-in-place.

Keywords: Medicare beneficiaries; aging-in-place; bathroom modifications; disparities; falls; fear of falling; repeated falls.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Cross-Sectional Studies
  • Fear
  • Humans
  • Independent Living*
  • Medicare
  • Toilet Facilities*
  • United States