The prevalence and determinants of home accidents among older men and women in Türkiye

Abstract

Background

The population is aging, and cases of geriatric trauma are becoming increasingly common. Home accidents represent a significant public health problem for older individuals. It is imperative that we recognize the special considerations that must be taken into account to provide appropriate care. The present study aims to identify the factors associated with home accidents among individuals aged 60 and over in Türkiye.

Methods

The study involved a descriptive and causal-comparative quantitative research design. Microdata obtained from the Türkiye Health Survey conducted by the Turkish Statistical Institute in 2019 and 2022 were used, with a sample size of 8,225 older adults. A stratified two-step cluster sampling method was employed. The study’s dependent variable was the occurrence of home accidents, measured by means of the question “Have you experienced a home accident resulting in injury in the last 12 months? (Yes, No).” The independent variables were those available in the Türkiye Health Survey. Frequencies and percentages were obtained considering the home accident occurrence and years among the older participants. Binary logistic regression (enter) analyses were then applied to identify the risk factors affecting home accidents in older individuals.

Results

The probability of home accidents in 2019 and 2022 was 50.2% and 50.4% higher, respectively, in women compared to men. The probability of home accidents among older individuals who were illiterate or had not completed any schooling was 67.4% lower than those educated to elementary school level or higher in 2019. Home accidents were 42% less likely among married older individuals, and 24.4% less probable among employed individuals, in 2022. The probability of home accidents among older individuals with arthrosis was 65.7% lower in 2019 compared to those without arthrosis.

Conclusion

Individuals of advanced age are susceptible to accidents in their domestic environments. A wide spectrum of factors contributes to the occurrence of such accidents. The prevention of home accidents requires an awareness of the risk factors involved, an enhancement of programs designed to facilitate healthy aging, and an increased emphasis on preventive measures. Some lifestyle modifications (exercise, nutritional therapy, home design, and the use of assistive devices) can be employed to minimise the risk factors for falls in older individuals, and the medications they use for morbid conditions should be reviewed. Improving the self-care skills of the geriatric population, educating and supporting the older adult and their carers will reduce the number of traumatic injuries requiring hospitalisation.

Introduction

Home accidents are a significant public health issue in both developed and developing countries [1]. The home is where older individuals spend the majority of their time, thus increasing the likelihood of accidents of any kind in that setting. Home accidents are more common among older individuals and can have severe health impact [2]. Individuals aged 65 and above are at a particularly high risk of such accidents due to physical, psychological, and social impairments. Musculoskeletal problems and sensory and motor function losses in this group further increase the risk of accidents [3]. Home accidents are assumed to be unintentional and can range from minor injuries to mortality. These accidents can occur within the home and in surrounding areas such as garages, gardens, terraces, and stairs [4]. A home accident is defined as an incident that occurs suddenly and unexpectedly within the home or its immediate surroundings (such as the garden, garage, or stairs), typically resulting in physical harm to the individual. While unintentional home and recreational injuries pose a particular risk for individuals aged 85 and older, outdoor injuries also represent a risk for the younger geriatric population (aged 75–79) [5].

Home accidents represent a significant health problem in terms of morbidity and mortality at older ages [6]. Falls in the home environment account for over 33% of accidents and represent the second leading cause of death and the main cause of injury in more than 41.2% of cases [7]. Falls occurring in the bathroom, hallway, living room, or bedroom or caused by features of the floor or stairs can result in physician visits and hospitalizations [1].

Older individuals may also experience traumas as a result of accidents in the home. These traumas may have severe consequences for older adults, leading to increased rates of illness and death [8]. The proportion of older individuals presenting to Level I and II trauma centers in one study was 23% in 2003, rising to 30% in 2009 [9]. This rate is predicted to reach 39% by 2050 [10]. The cost of home accidents is estimated to be 3.5 times higher than that of traffic accidents [11].

Geriatric trauma is a rapidly developing area of interest within the field of emergency medicine. The most recent data indicate that geriatric patients represent 30.75% of all trauma cases [12]. The mortality rate due to trauma increases significantly with age. The expected mortality rate in trauma patients in the middle age group (35–45 years) is 3.35, compared to 6.66 in those over 75. An increasing mortality rate has also been reported in older patients in the 12 months following trauma that does not cause serious system injury [13].

Patients aged 65 and over who present to the emergency department with trauma have a mortality rate of 11% following falls. The frequency of hospital and intensive care unit admissions and length of hospital stay are both higher than in younger patients. The presence of comorbidities in the geriatric population, together with the physiological changes associated with advanced age, require particular consideration when determining normal vital signs. Such individuals are more likely to die within five years of any traumatic injury [14]. The age-related decline in physiological function in multiple organ systems also raises the probability of both falls and unfavorable outcomes post trauma [15].

The implementation of community screening through home inspections and questionnaires, as an official policy, coupled with the development of therapeutic prevention strategies tailored to the screening results, has the potential to reduce the incidence of falls among the geriatric population. However, the impacts of these measures on the prevalence of traumatic injury, the allocation of health resources, and health-related quality of life remains uncertain. Reviews and meta-analyses have examined a number of preventive measures. However, the question of what constitutes a definitive preventive intervention remains unanswered [16, 17].

The diminished capacities of older individuals frequently result in limitations in activities of daily living. Aging and declining individual capacities increase the prevalence of disease and disability among older individuals. Living at home, which is associated with independence and autonomy-related physical, psychological, and psychosocial benefits, is a desired and essential goal for older individuals [18]. It is therefore important to examine the factors contributing to home accidents among the older population in order to ensure domestic safety. This study therefore investigated the risk factors affecting home accidents among individuals aged 60 and over in Türkiye.

Falls represent the most common mechanism of trauma in the geriatric population the majority occurring within the domestic environment. The aim of this study was to determine risk factors potentially responsible for falls among older households compiled by the Turkish Statistical Institute (TSI) and to shed light on future studies by predicting preventive interventions. Further research is required to develop effective interventions for preventing falls in older individuals with multiple comorbidities. This can be achieved by identifying specific risk factors associated with this population.

Method

Study design

Descriptive and causal-comparative quantitative research methods were used in this study. The Türkiye Health Survey is a significant research tool that reflects the entire country and enables national and international comparisons to be made. The dataset includes a wide range of health indicators related to the well-being of infants, children, and adults, together with insights into individuals’ access to healthcare services. The survey is designed to produce estimates for the total population at rolling 10-year age intervals [19].

Setting

The Türkiye Health Interview Survey was first carried out by the TSI in 2008, and then every two years until 2016. The survey yields numerous health indicators, including the health conditions of infants, children, and adults, the use of health services, difficulties faced during daily activities, and cigarette and alcohol use for individuals aged 15 and over. All individuals living in Türkiye were covered. The institutional population (such as members of the military, individuals living in dormitories, prisons, the long-term hospitalized, and residents of homes for the older adults) and very small settlements where a sufficient number of sample households could not be obtained (small villages, hamlets, etc.) were excluded [19].

Participants

Table 1 presents the findings related to factors associated with home accidents among older individuals. This shows that 53.9% of the older individuals in the study were female and 46.1% were male. In addition, 46.4% were elementary school graduates, 70.9% were married, 90.6% were not employed, 24.7% reported poor/very poor overall health status, 21.3% had arthrosis, 20% experienced urinary incontinence, 68% wore glasses, 53.7% experienced difficulty carrying or holding items, and 9.4% faced challenges in meeting health service costs.

Table 1.

Factors affecting home accidents among older individuals

Variables		Whole Model		2019		2022
		n	%	n	%	n	%
Sex
Male		3,795	46.1	1,633	45.4	2,162	46.7
Female		4,430	53.9	1,962	54.6	2,468	53.3
Educational level
Illiterate/Ungraduated		2,514	30.6	1,211	33.7	1,303	28.1
Elementary school		3,814	46.4	1,642	45.7	2,172	46.9
Higher than elementary school		1,897	23.1	742	20.6	1,155	24.9
Marital status
Married		5,832	70.9	1,090	30.3	3,327	71.9
Single		2,393	29.1	2,505	69.7	1,303	28.1
Employment status
Employed		774	9.4	388	10.8	386	8.3
Unemployed		7,451	90.6	3,207	89.2	4,244	91.7
General health status
Very good/Good		2,343	28.5	979	27.2	1,364	29.5
Moderate		3,848	46.8	1,583	44.0	2,265	48.9
Poor/Very poor		2,034	24.7	1,033	28.7	1,001	21.6
Arthrosis
Yes		1,748	21.3	928	25.8	820	17.7
No		6,477	78.7	2,667	74.2	3,810	82.3
Urinary incontinence
Yes		1,648	20.0	886	24.6	762	16.5
No		6,577	80.0	2,709	75.4	3,868	83.5
Using glasses
Yes/cannot see at all		5,597	68.0	2,581	71.8	3,016	65.1
No		2,628	32.0	1,014	28.2	1,614	34.9
Difficulty in carrying or holding objects
No difficulty		3,805	46.3	1,530	42.6	2,275	49.1
Slight difficulty/high level of difficulty/cannot do at all		4,420	53.7	2,065	57.4	2,355	50.9
Able to meet healthcare expenses
Yes		775	9.4	313	8.7	4,168	90.0
No		7,450	90.6	3,282	91.3	462	10.0
Survey year
2019		3,595	43.7	-	-	-	-
2022		4,630	56.3	-	-	-	-

Variables

Older individuals are at risk for home accidents due to their developmental characteristics [2, 3].

Data from individuals aged 60 and above were used in this study. The dependent variable was the occurrence of home accidents, measured by the question, “Have you experienced a home accident resulting in injury in the last 12 months? (Yes, No).” In the established model, the dependent variable categories were assigned a score of 1 if the individual had experienced a home accident and otherwise of 0.

Data sources/measurement

This study employed the cross-sectional data from the Türkiye Health Survey conducted in 2019 and 2022 by the TSI. The most recent Türkiye Health Survey data made available by the TSI were those for 2022.

The Türkiye Health Survey is intended to elicit information about health indicators, which include a large part of the development indicators that show countries’ degrees of development. This survey is highly important as the first study that reflects the country as a whole and both international and national needs [19].

The data were originally produced through the joint activities of the TSI and the European Union Statistical Office (SOEU). We obtained this data from the TSI without the need for an ethics committee document and used it in the study.

Bias

The replies to the questions asked in the Türkiye Health Survey are based on personal statements. However, this entailed the risk that any data obtained using this method might be biased.

Study size

A stratified two-step cluster sampling method is used in the survey. As the criterion of external stratification, the rural-urban divide is employed to determine external stratification. (settlements with a population of 20,000 or less being regarded as rural and those with 20,001 or above as urban). The first stage sampling unit consists of randomly selected blocks proportional to the size of clusters (blocks) containing an average of 100 addresses. The second stage sampling unit consists of systematically, randomly selected household addresses from each cluster [19].

The data set from the 2019 and 2022 surveys conducted by the TSI was used in the present study following the provision of a signed letter of intent. The most recent Türkiye Health Survey data published by the TSI were for 2022. The 2019 Health Survey was conducted with 9,470 households and the 2022 survey with 11,170.

Data obtained from 8,225 older adults in the Türkiye Health Survey for 2019 and 2022 were included in the analysis.

Quantitative variables

The independent variables included in the study were those available in the Türkiye Health Survey. These were selected as risk factors based on the current literature [5, 20–28].

The independent variables of this study were gender (female, male), education level (illiterate/lower than elementary school, elementary school, secondary school and above), marital status (single, married), employment status (unemployed, employed), general health status (very good/good, fair, poor/very poor), presence of arthrosis (no, yes), urinary incontinence (no, yes), the use of glasses (yes/cannot see at all, no), difficulty in carrying or holding items (no difficulty, some difficulty/considerable difficulty/cannot do at all), difficulty in affording health care services (no, yes), and survey year (2019, 2022).

All the analyzed variables were categorical variables and bi-stable or ordinary scales. Ordinal and nominal variables were described as dummy variables in order to observe the impact of the categories belonging to all the variables that would be integrated into the binary logistic regression [29].

Statistical methods

Survey statistics in Stata 15 (Stata Corporation) were used to address the complex sampling design and weights. Weighted analysis was conducted. Initially, frequencies and percentages were obtained in terms of the incidence and years of home accidents. Binary logistic regression (enter) analyses were subsequently employed to identify the risk factors affecting home accidents among older individuals.

In the social sciences, and particularly in socio-economic research, some of the variables examined are measured on a sensitive scale, while others consist of dichotomous data such as positive-negative, successful-unsuccessful, and yes-no. Dichotomous data are the most commonly used form of categorical data. When the dependent variable consists of dichotomous categorical data, logistic regression analysis is applied to examine the cause-and-effect relationship between the dependent variable and the independent variable(s) [30].

Logistic regression is a statistical method that permits classification in accordance with probability rules by calculating the predicted values of the dependent variable as probabilities [31].

The logistic model was initially developed for use in survival analysis. Here, the dependent variable (Y) assumes values of 1 or 0, depending on whether the event of interest occurs. The expected value, E(Y), never falls below 0 or rises above 1. The predicted values of in the logistic model therefore range between 0 and 1 [32, 33].

The logistic model is written as,

1

After dividing the numerator and denominator of Eq. 1 by or exp

2

In the equation, there is a condition that and X values are qualitative or quantitative independent variables

Results

The presence of multicollinearity among the independent variables to be included in the binary logistic regression model was tested. The variance inflation factor (VIF) indicates that variables with values of 5 and above cause moderate multicollinearity, while those with values of 10 and above result in high multicollinearity [34]. No variable causing multicollinearity was identified among the independent variables in this study. The estimated results of the binary logistic regression model are presented in Table 2.

Table 2.

Estimated model results for factors associated with home accident occurrence among older individuals

Variables		Whole Model		2019		2022
		β	Standard error	β	Standard error	β	Standard error
Constant		−3.638*** (p=0.000)	0.276	−3.436*** (p=0.000)	0.340	−4.138*** (p=0.000)	0.420
Sex (Reference: Male)
Female		0.514** (p=0.004)	0.177	0.521* (p=0.029)	0.238	0.517 (p=0.051)	0.265
Education (Reference: Higher than elementary school)
Illiterate/Ungraduated		−0.453* (p=0.031)	0.210	−0.705* (p=0.012)	0.281	−0.175 (p=0.570)	0.308
Elementary school		−0.229 (p=0.239)	0.195	−0.372 (p=0.166)	0.269	−0.101 (p=0.719)	0.281
Marital status (Reference: Single)
Married		−0.336* (p=0.017)	0.141	−0.261 (p=0.163)	0.187	−0.432* (p=0.043)	0.214
Employment status (Reference: Unemployed)
Employed		−0.828 (p=0.058)	0.437	−0.521 (p=0.286)	0.488	−2.069* (p=0.039)	1.004
General health status (Reference: Poor/Very Poor)
Very Good/Good		−0.613** (p=0.005)	0.219	−0.698* (p=0.017)	0.293	−0.494 (p=0.130)	0.327
Moderate		−0.558*** (p=0.000)	0.153	−0.657** (p=0.002)	0.213	−0.461* (p=0.034)	0.217
Arthrosis (Reference: No)
Yes		0.462** (p=0.002)	0.149	0.686*** (p=0.001)	0.199	0.150 (p=0.512)	0.229
Urinary incontinence (Reference: No)
Yes		0.636*** (p=0.000)	0.151	0.655** (p=0.002)	0.208	0.623** (p=0.004)	0.215
Using glasses (Reference: No)
Yes/cannot see at all		0.340* (p=0.038)	0.164	0.307 (p=0.174)	0.226	0.368 (p=0.118)	0.236
Difficulty in carrying or holding objects (Reference: No difficulty)
Slight difficulty/high level of difficulty/cannot do at all		0.451* (p=0.011)	0.178	0.310 (p=0.175)	0.229	0.640* (p=0.023)	0.281
Able to meet healthcare expenses (Reference: No)
Yes		0.324 (p=0.087)	0.189	0.176 (p=0.513)	0.269	0.479 (p=0.071)	0.266
Survey year (Reference: 2019)
2022		−0.252 (p=0.065)	0.137	-	-	-	-

^*p < 0.05, ^**p < 0.01, ^***p < 0.001

The variables identified as affecting the occurrence of home accidents in this study were the year of the survey, gender, education level, marital status, employment status, the individual’s working and overall health status, the presence of arthrosis, urinary incontinence, the use of glasses, difficulty in carrying or holding items, and difficulty in meeting health service costs.

The marginal effects of factors associated with home accidents among older individuals are shown in Table 3.

Table 3.

Marginal effects of factors associated with the occurrence of home accidents among older individuals

Variables		Whole Model		2019		2022
		Marginal effects	Standard error	Marginal effects	Standard error	Marginal effects	Standard error
Sex (Reference: Male)
Female		0.499** (p=0.004)	0.173	0.502* (p=0.029)	0.230	0.504 (p=0.052)	0.259
Education (Reference: Higher than elementary school)
Illiterate/Ungraduated		−0.437** (p=0.030)	0.202	−0.674* (p=0.012)	0.267	−0.170 (p=0.570)	0.299
Elementary school		−0.220 (p=0.238)	0.187	−0.353 (p=0.165)	0.254	−0.098 (p=0.719)	0.273
Marital status (Reference: Single)
Married		−0.325* (p=0.017)	0.136	−0.251 (p=0.163)	0.180	−0.420* (p=0.043)	0.207
Employment status (Reference: Unemployed)
Employed		−0.809 (p=0.060)	0.430	−0.505 (p=0.289)	0.476	−2.044* (p=0.041)	1.000
General health status (Reference: Poor/Very Poor)
Very Good/Good		−0.592** (p=0.005)	0.212	−0.670* (p=0.018)	0.283	−0.480 (p=0.131)	0.318
Moderate		−0.539*** (p=0.000)	0.148	−0.630** (p=0.002)	0.204	−0.448* (p=0.034)	0.211
Arthrosis (Reference: No)
Yes		0.446** (p=0.002)	0.143	0.657** (p=0.001)	0.190	0.146 (p=0.511)	0.222
Urinary incontinence (Reference: No)
Yes		0.613*** (p=0.000)	0.145	0.628*** (p=0.002)	0.199	0.604** (p=0.004)	0.207
Using glasses (Reference: No)
Yes/cannot see at all		0.330* (p=0.038)	0.159	0.296 (p=0.175)	0.218	0.359 (p=0.119)	0.230
Difficulty in carrying or holding objects (Reference: No difficulty)
Slight difficulty/high level of difficulty/cannot do at all		0.437* (p=0.012)	0.173	0.299 (p=0.176)	0.221	0.625* (p=0.023)	0.275
Able to meet healthcare expenses (Reference: No)
Yes		0.312 (p=0.086)	0.182	0.169 (p=0.512)	0.257	0.464 (p=0.070)	0.256
Survey year (Reference: 2019)
2022		−0.244 (p=0.065)	0.132	-	-	-	-

^*p < 0.05, ^**p < 0.01, ^***p < 0.001

As shown in Table 3, the probability of women experiencing home accidents in 2019 and 2022 was 50.2% and 50.4% higher, respectively, than in men. The probability of home accidents among older individuals who were illiterate or had not completed any schooling was 67.4% lower than in those educated to elementary school level or higher in 2019. The probability of home accidents among married older individuals is 42% lower in 2022. The probability of home accidents among employed older individuals was 24.4% lower in 2022. In addition, home accidents were 67% less likely among older individuals with very good/good overall health in 2019 compared to those with poor/very poor health. The probability of home accidents among older individuals with moderate overall health was 63% and 44.8% lower in 2019 and 2022, respectively, compared to those with poor/very poor health. The probability of home accidents among older individuals with arthrosis was 65.7% lower in 2019 compared to those without arthrosis.

The probability of home accidents among older individuals with urinary incontinence was 62.8% and 60.4% higher in 2019 and 2022, respectively, compared to those with no urinary incontinence. The probability of home accidents was also 33% greater in the entire model among older individuals who wore glasses or had no vision than in those without glasses or with vision. The probability of home accidents among older individuals with some difficulty/a lot of difficulty/inability to carry anything was 62.5% higher in 2022. The probability of home accidents among individuals with difficulty in affording health expenses was 46.4% higher in 2022. Finally, the probability of home accidents among older individuals was 24.4% lower in 2022 than in 2019.

Discussion

This study investigated the factors affecting the likelihood of home accidents among older individuals in Türkiye.

Older women in this study had a higher likelihood of home accidents. Previous studies also suggest that women are at a higher risk of such accidents [24, 25, 28]. Within the context of gender roles, household chores and responsibilities are typically undertaken by women [35]. In Türkiye, men frequently perceive household chores as feminine tasks, leading to a tendency for women to be responsible for them [36]. Increased involvement in household chores and spending more time at home may therefore have increased the likelihood of home accidents among women.

The study results also showed that older individuals with lower levels of education were less likely to experience home accidents. However, previous studies have also reported lower injury rates in older individuals with higher levels of education [23]. A higher education level among older individuals is associated with increased social participation [37]. Highly educated individuals being more socially active may reduce the amount of time spent at home. The results of the present study yielded an apparently unrealistic conclusion, suggesting that individuals with lower education levels have a lower likelihood of experiencing home accidents. Additionally, lower education levels may lead to lower income [38]. Older individuals with lower education levels may not receive a pension or may have a low income, leading them to work outside the home. In this study, employed individuals had a lower likelihood of home accidents. The reduced likelihood of home accidents among older individuals with lower education levels may be due to their spending less time at home due to engagement in external activities.

In this study, married older individuals exhibited a lower likelihood of home accidents. Previous studies involving falls, which are regarded as home accidents, also reported a lower risk in married individuals [20, 26]. The protective effect of marital status may be related to the early detection of balance and walking problems that may lead to injuries such as falls [39]. Additionally, a higher quality of life has also been reported in married older individuals [40]. A higher quality of life among married individuals may increase the likelihood of their living in safer homes, which may in turn prevent home accidents.

Events such as depression also increase the risk of falls [41]. Older individuals without a spouse are more likely to feel lonely and to have physical, cognitive, and sensory limitations [42]. Married older individuals tend to experience less loneliness and depression than the unmarried. It may be postulated that married older individuals can reduce factors that increase the risk of accidents, such as distraction and lack of concentration.

The results of this study showed that older individuals in good overall health had a lower likelihood of home accidents. The presence of comorbidities such as diabetes, hypertension, osteoporosis, and hyperlipidemia has previously been shown to raise the risk of falls and fractures in the older population [43].

Older individuals with arthrosis had a lower likelihood of home accidents. Joint diseases are considered a risk factor for falls in the older population [21, 27]. Individuals with common diseases frequently experience a fear of falling due to the symptoms of the disease [44]. Fear of falling among older individuals can lead to decreased mobility and limitations in daily activities [45, 46]. Older individuals restricting their movements due to a fear of falling may have led to this finding.

Individuals with urinary incontinence were also more likely experience home accidents. Urinary incontinence can impair physical function and mobility among the older population [47]. Moreover, urinary incontinence and related symptoms can increase the frequency of toilet visits. Impaired mobility and efforts to reach the toilet can also lead to home accidents among older individuals.

Older individuals who wear glasses or have poor vision also have a greater likelihood of home accidents. Vision problems can significantly increase the risk of falls [28, 48, 49]. Older individuals with vision impairments have been reported to be more prone to home accidents [28]. Vision problems can increase the likelihood of falls due to their effect on depth perception and visual acuity.

Home accidents are also more likely among older individuals with some difficulty/considerable difficulty in carrying items or who are unable to do so. Skeletal muscle performance issues and loss of muscle strength in older individuals can reduce their ability to pick up and move items [43, 50]. This may make it difficult for them to carry objects, thus increasing the likelihood of accidents.

Individuals experiencing difficulty in paying for health services are also more likely to experience home accidents. Economic poverty can increase the probability of domestic accidents [5]. Poverty leads to a poorer physical home environment, which can contribute to home accidents [51].

The likelihood of older individuals experiencing home accidents decreased in 2022 compared to 2019. The COVID-19 pandemic was reported to have significantly affected older adults’ lifestyles and activity levels in 2020 and 2021. People generally stayed at home during the pandemic, and older individuals may have been more cautious at home due to reluctance to go out, crowded hospitals, and reduced accessibility. However, further systematic monitoring studies are now needed to assess the long-term effects of this decrease.

Conclusion

Older individuals are at risk of home accidents, with numerous factors affecting their occurrence. In Türkiye, the year, gender, education level, marital status, employment status, the individual’s overall health status, the presence of arthrosis, urinary incontinence, the use of glasses, experiencing difficulty in carrying or holding items, and challenges in paying for health services all emerged as influential variables contributing to home accidents.

The findings of this study indicate that older women in Türkiye are at an elevated risk of home accidents. Individuals with higher levels of education in Türkiye are also more prone to such accidents. The study findings also revealed that being married and being employed act as protective factors against home accidents among older individuals. A negative perception of overall health, along with the presence of joint diseases, urinary incontinence, difficulty in carrying items, and financial constraints related to healthcare costs, were identified as risk factors for home accidents among the older population in Türkiye in the present research.

The analyses demonstrated an inter-relationship between various factors in home accidents among older individuals, emphasizing the need to considering these factors collectively. When planning of future research, it will be beneficial to consider the development of models for the prevention of home accidents and the implementation of protective measures against such accidents among older individuals, taking into account the variables discussed above.

This study also identified female gender and living alone in old age as risk factors for falls, suggesting a need for policies aimed at encouraging increased vigilance among older women living alone in terms of home accidents. Moreover, since vision problems can lead to falls in the older population, visual technologies may need to be developed in order to improve vision-related issues among this group. Since urinary incontinence in old age is also a risk factor for falls, we recommend that to special training on urinary incontinence be included in active ageing programs. Public health education programs might usefully prioritize the issue of home accidents and their risks under the umbrella of healthy ageing. Given that musculoskeletal problems among older individuals can lead to difficulties in carrying items, we also recommend that incentives for engagement in physical activity to enhance muscle mass in older individuals be developed.

Limitations and future research

This study has a number of limitations. Firstly, the data used in this study are secondary data. The variables necessary for statistical analysis rely on the available dataset. There are no different variables or laboratory findings.

In the future, studies aiming to prevent home accidents among older individuals can be carried out by considering these risk factors. Moreover, studies comparing Türkiye with other countries can be planned.

Author’s contributions

ÖA conceived and led the design and development of the study proposal. ÖA and EB supervised data collection, led the data analysis and drafting the manuscript. EB, MG and AG made substantial contributions to the conceptualization and design of the study, data interpretations and writing of the manuscript. All authors read and approved the final version of the manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Data availability

The data underlying this study is subject to third-party restrictions by the Turkish Statistical Institute. Data are available from the Turkish Statistical Institute (bilgi@tuik.gov.tr) for researchers who meet the criteria for access to confidential data. The authors of the study did not receive any special privileges in accessing the data.

Declarations

Ethics approval and consent to participate

The data were obtained through the joint teamwork of both the Turkish Statistical Institute and the European Union Statistical Office. We obtained this data from TSI in return for a contract without needing an ethics committee document and used it in our study.

The TSI is an institution that compiles, evaluates, and presents statistical information to decision-makers to prepare development plans and programs, make economic decisions, and address all other issues needed. It carries out internationally comparable statistical production activities according to the standards of organizations such as the European Union Statistical Office, the United Nations, OECD, ILO, etc. The TSI collects data within the scope of the Official Statistics Program. The Official Statistics Program is prepared for five-year periods based on the Turkish Statistics Law No. 5429 to determine the basic principles and standards regarding the production and publication of official statistics and to ensure the production of up-to-date, reliable, timely, transparent and impartial data in areas of need at national and international levels (52). TSI also conducts the Türkiye Health Survey within the scope of the Official Statistics Program put into effect by law. Since the Türkiye Health Survey is conducted within the scope of legal responsibility by the state, ethical approval is not required (53).

For this study, secondary data were employed. Official approval was received from the Turkish Statistical Institute to use the microdata set from the Türkiye Health Survey. The Türkiye Health Survey provides many indicators in the field of health, including the utilization of health services by individuals aged 15 and over, the degree of difficulty they experience in performing their daily activities, and their smoking and alcohol use habits. The TSI also received a “Letter of Undertaking” authorizing it to use the study’s data.

The letter of undertaking for the use of micro data without restrictions in dissemination:

Article 1- This letter of undertaking determines the rules, principles and obligations of the use of micro data, which are safe to disclose apart from the Presidency.

Article 2-This letter of undertaking regulates the use of micro data sets of Türkiye Health Survey in 2019, 2022, within the framework of the Directive on Access and Use of Micro Data in line with the purpose specified in Article 1.

Article 3- The following provisions apply for the use of micro data:

1. Findings obtained by the researcher as a result of incorrect calculation only bind the researcher.

2. The researcher refers to the micro data of the Institution that he uses while disclosing the results obtained from the study.

3. The researcher is obliged to send a copy of the published report, article, publication etc. to the Institution Library within three months at the latest. Subsequent micro data usage requests of the researcher who is found not to fulfill this obligation are not covered.

4. The researcher cannot reproduce, give to third parties, sell or transfer the micro data set he obtained.

Article 4-The researcher, by taking into account the principles of confidentiality defined in 13. and 14. articles of TSI numbered 5429 and Regulation on Procedures and Principles Regarding Data Confidentiality and Confidential Data Security in Official Statistics, is deemed to guarantee hereby that he shall not disclose the information, table, etc. violating this principle and shall only use micro data for statistical purposes.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.