Objectively Measured Physical Activity Predicts Falls in a Cohort of Community Dwelling Older Men

Background: Too much or too little physical activity (PA) may increase risk of falls in older adults. To date, no studies have investigated how objectively-measured PA predicts falls in community-dwelling older adults.

Methods: 1655/1708 (97%) men aged 71-91 years participating in an established UK population-based cohort study wore a GT3x accelerometer over the hip for one week in 2010-12. 825 reported whether they had fallen one year later. Multinomial regression models estimated relative risk ratios (RRRs) of single or recurrent falls compared to no fall.

Results: Among 700 ambulatory men with ≥600 minutes of accelerometer wear on ≥3 days, 9%(n=61) reported a single fall and 10%(n=67) recurrent falls one year later. Associations between baseline PA and falls differed by presence of mobility limitations. Among 471 (66%) men without mobility limitations, the risk of a single fall increased with greater activity: (RRR 1.05 (95%CI 1.01, 1.09) per 1000 steps/day; RRR 1.42 (95%CI 0.99, 2.02) per 30 minutes of moderate to vigorous PA (MVPA) in analyses adjusted for falls risk factors. Among 229 (33%) men with mobility limitations, RRR of single fall was 0.69 (95%CI 0.52, 0.92) per 1000 steps/day and 0.51 (95%CI 0.24, 1.07) per 30 minutes of MVPA, RRR of recurrent falls was 0.47 (0.23, 0.96) per 30 minutes of MVPA.

Conclusion: Programmes to encourage older men with no mobility limitations to be physically active may need to incorporate falls prevention strategies to avoid excess falls. In contrast, encouraging MVPA among adults with mobility limitations may help reduce falls risks.