Many older adults want to stay in their own homes for as long as possible. Living independently can improve quality of life, but it also comes with challenges.
One of the biggest is the risk of falling, which increases with age and can lead to broken bones, disability, loss of confidence, and even the need for long-term care.
Falls are already a major public health problem. In England, about one in three people aged 65 and older falls at least once every year. Many recover quickly, but others need hospital treatment or rehabilitation, and some never regain their previous level of independence.
Doctors have long known that poor balance, weak muscles, poor eyesight, and certain medications increase the chance of falling. However, researchers are also becoming more interested in the role of the home itself. Hazards inside the house may quietly increase the risk every day.
A new study led by researchers at the London School of Economics and Political Science found that older people living in homes with electrical or plumbing problems, not enough living space, or poor lighting were more likely to experience falls.
The researchers analyzed information from about 5,500 adults aged 65 and older who took part in the English Longitudinal Study of Ageing between 2002 and 2023. Participants answered questions about the condition of their homes and reported whether they had experienced falls.
The results showed that electrical or plumbing problems were linked to a 10.8% higher chance of falling. These home problems were also associated with falls serious enough to require medical care.
Limited space inside the home was another important factor. Older adults living in crowded homes had a 3.3% higher risk of falling, possibly because it is harder to move around safely or avoid obstacles.
Poor lighting also stood out. Although it was not linked to every fall, it was associated with a 9.3% higher chance of falls that required healthcare. Good lighting is especially important because eyesight often becomes weaker with age, making it harder to notice steps, loose rugs, or other hazards.
The researchers estimated that falls linked to poor housing cost England about £1.2 billion every year. This included around £440 million in healthcare costs and another £778 million for formal care services.
The authors noted some limitations. Housing conditions and falls were self-reported, so some participants may not have remembered every detail correctly. The economic estimates were also based partly on previous research rather than direct measurements.
Even with these limitations, the findings suggest that improving housing conditions could become an important part of preventing falls. Simple changes such as repairing electrical and plumbing faults, improving lighting, and reducing clutter may help many older adults remain safe and independent.
The study was published in PLOS One.
Overall, this large long-term study provides strong evidence that the condition of a home can affect the health of older adults. While it cannot prove that poor housing directly causes falls, the findings support investing in safer housing alongside exercise, vision checks, and medication reviews. Preventing falls could improve quality of life while also reducing healthcare costs.
Source: London School of Economics and Political Science.
