Effects of Daily Physical Activity on Falls Risk. A Comparative Analysis Between Institutionalized and Community-Dwelling Elderly Adults

Introduction Strategies to increase daily physical activity may be viewed as a mean to counteract the high prevalence of falls in elderly subjects, which is an important and increasing single factor associated with disability, injury and death. On the other hand when the elderly have reduced autonomy and consequent need of institutionalization the social cost to support this prevalent scenario continues to rise. Thus, the present study aimed to evaluate the effect of daily physical activity, on balance, lower limbs strength and fear of falling in non-institutionalized (NI) and institutionalized (I) elderly subjects.

Methods This cross-sectional study included 40 institutionalized and 38 community-dwelling older adults aged 65 to 90 years. For data collection we used a social demographic questionnaire, the Tinetti Scale for balance assessment, the Falls Eficacy Scale (FES) to assess fear of falling based on the operational definition of fear as low perceived self-efficacy or confidence at avoiding falls’ (Tinetti et al, 1990) and validated for Portuguese population, and 30 seconds chair sit-to- stand for lower limbs strength assessment. Moreover, accelerometers (Actigraph GT1M) were used by the sample during 7 consecutive days for daily physical activity assessment. Data were verified for normality of distribution by Kolmogarov-Smirnov test. Impaired Student’s t-test was used to compare means between groups and when the variables departed from normality, the Mann-Whitney test was used instead.

Results Data showed that the institutionalized older adults present lower daily physical activity (MVPA: I- 250,11±218,52 min/week vs NI- 543,37±237,73; p= 0,000) as well as less balance (Static balance: I – 9,36±3,40 vs NI -12,86±2,76, p=0,000 and Dynamic balance: I- 8,05±2,79 vs NI-11,16±1,90; p=0,000), increased fear of falls (I- 63,93±20,49 vs NI- 88,81±14,51; p=0,03) and lower muscle strength (I – 10,70 reps vs 18,76 reps, p=0,00) compared to non institutionalized elderly peers.

Conclusions These results suggest that increase daily physical activity habits may be an effective strategy to positively influence fall risk in elderly subjects. Furthermore, this study supports the idea that health care homes and institutionalizations for older subjects should promote Physical Activity instead of restricted it in order to prevent frailty.

References Tinetti, M.E., Richman, et al. (1990). Journal of Gerontology 45(6): P239-43. Acknowledgement This research was funded by the Portuguese Foundation of Science and Technology (FCT), grant FCOMP-01-0124-FEDER-009587 – PTDC/DES/102094/2008. E. A. Marques, and J. Mota are supported by grants from Portuguese FCT (SFRH/BD/36319/2007 and SFRH/BSAB/1025/2010 respectively).