How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men?

Abstract

BackgroundFalls affect approximately one third of community-dwelling older adults each year and have serious health and social consequences. Fear of falling (FOF) (lack of confidence in maintaining balance during normal activities) affects many older adults, irrespective of whether they have actually experienced falls. Both falls and fear of falls may result in restrictions of physical activity, which in turn have health consequences. To date the relation between (i) falls and (ii) fear of falling with physical activity have not been investigated using objectively measured activity data which permits examination of different intensities of activity and sedentary behaviour.MethodsCross-sectional study of 1680 men aged 71–92 years recruited from primary care practices who were part of an on-going population-based cohort. Men reported falls history in previous 12 months, FOF, health status and demographic characteristics. Men wore a GT3x accelerometer over the hip for 7 days.ResultsAmong the 12% of men who had recurrent falls, daily activity levels were lower than among non-fallers; 942 (95% CI 503, 1381) fewer steps/day, 12(95% CI 2, 22) minutes less in light activity, 10(95% CI 5, 15) minutes less in moderate to vigorous PA [MVPA] and 22(95% CI 9, 35) minutes more in sedentary behaviour. 16% (n = 254) of men reported FOF, of whom 52% (n = 133) had fallen in the past year. Physical activity deficits were even greater in the men who reported that they were fearful of falling than in men who had fallen. Men who were fearful of falling took 1766(95% CI 1391, 2142) fewer steps/day than men who were not fearful, and spent 27(95% CI 18, 36) minutes less in light PA, 18(95% CI 13, 22) minutes less in MVPA, and 45(95% CI 34, 56) minutes more in sedentary behaviour. The significant differences in activity levels between (i) fallers and non-fallers and (ii) men who were fearful of falling or not fearful, were mediated by similar variables; lower exercise self-efficacy, fewer excursions from home and more mobility difficulties.ConclusionsFalls and in particular fear of falling are important barriers to older people gaining health benefits of walking and MVPA. Future studies should assess the longitudinal associations between falls and physical activity.

Risk of falls in chronic kidney disease

“…A 7% of the patients experienced head injuries, with loss of consciousness, a 4% sustained fractures and 4% died due to an injury produced by the fall 2 . Moreover, except physical injuries, falls and disequilibrium can lead to 'fear of falling' which further restricts every day activities 8,12 , leads to depression 12 and reduces physical exercise such as walking 13 .…”

The relationship between physical fitness and falling risk and fear of falling in community-dwelling elderly people with different physical activity levels

“…Research must focus on building associations between PAL and falling risk or FOF without any bias (27). However, it is emphasized that sufficient physical activity and higher physical fitness might contribute to preventing falls and FOF (6,28,29 of physical inactivity (27). Our results showed that PAL might be ineffective on falling risk and FOF.…”

“…In previous studies, the general consensus is that physical activity has a close relationship with falling risk and FOF (8,27). Research must focus on building associations between PAL and falling risk or FOF without any bias (27).…”

“…In previous studies, the general consensus is that physical activity has a close relationship with falling risk and FOF (8,27). Research must focus on building associations between PAL and falling risk or FOF without any bias (27). However, it is emphasized that sufficient physical activity and higher physical fitness might contribute to preventing falls and FOF (6,28,29 of physical inactivity (27).…”

Potential analysis for research on occupational therapy-led physical exercise programmes and home environment adaptation programmes to prevent falls for elderly people living at home / Potenzialanalyse zu ergotherapeutischen körperlichen Trainingsprogrammen und Wohnraumanpassungen zur Vermeidung von Stürzen bei zu Hause lebenden älteren Menschen

“…Alltagsorientierte körperliche Trainingsprogramme zielen darauf ab, die Körperfunktionen zu verbessern und mobilitätsbezogene Risikofaktoren wie Stürze zu reduzieren (Jefferis et al, 2014). Sie können in monofaktorielle Trainingsprogramme (Cumming et al, 1999;Steultjens, Dekker, Bouter, Jellema, & Bakker, 2004;Clemson, Mackenzie, Ballinger, Close, & Cumming, 2008;Costello, & Edelstein, 2008;Sherrington et al, 2008;Davis et al, 2010;Sherrington, Tiedemann, Fairhall, Close, & Lord, 2011;Leland, Elliott, O'Malley, & Murphy, 2012) und in multifaktorielle Trainingsprogramme (Steultjens et al, 2004;Costello, & Edelstein, 2008;Peterson, & Clemson, 2008, Sherrington et al, 2008Davis et al, 2010;Sherrington et al, 2011;Leland, et al, 2012) eingeteilt werden.…”