Physical Activity and Different Concepts of Fall Risk Estimation in Older People–Results of the ActiFE-Ulm Study

Abstract

ObjectivesTo investigate the relationship between physical activity and two measures of fall incidence in an elderly population using person-years as well as hours walked as denominators and to compare these two approaches.DesignProspective cohort study with one-year follow-up of falls using fall calendars. Physical activity was defined as walking duration and recorded at baseline over one week using a thigh-worn uni-axial accelerometer (activPAL; PAL Technologies, Glasgow, Scotland). Average daily physical activity was extracted from these data and categorized in low (0–59 min), medium (60–119 min) and high (120 min and more) activity.SettingThe ActiFE Ulm study located in Ulm and adjacent regions in Southern Germany.Participants1,214 community-dwelling older people (≥65 years, 56.4% men).MeasurementsNegative-binomial regression models were used to calculate fall rates and incidence rate ratios for each activity category each with using (1) person-years and (2) hours walked as denominators stratified by gender, age group, fall history, and walking speed. All analyses were adjusted either for gender, age, or both.ResultsNo statistically significant association was seen between falls per person-year and average daily physical activity. However, when looking at falls per 100 hours walked, those who were low active sustained more falls per hours walked. The highest incidence rates of falls were seen in low-active persons with slow walking speed (0.57 (95% confidence interval (95% CI): 0.33 to 0.98) falls per 100 hours walked) or history of falls (0.60 (95% CI: 0.36 to 0.99) falls per 100 hours walked).ConclusionFalls per hours walked is a relevant and sensitive outcome measure. It complements the concept of incidence per person years, and gives an additional perspective on falls in community-dwelling older people.

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

“…Klenk et al reported that physical inactivity was not a risk factor for falls, but increasing PAL with improving physical fitness components might be protective against falls. In reduction of falling risk and FOF, physical fitness may be a more decisive factor than PAL (7). In parallel to that study, falling risk and FOF were found to be associated with physical fitness in both groups through further analysis.…”

“…Gouevia et al and Furtado report that more active elderly people have increased proficiency and higher physical fitness including muscular strength, flexibility, balance, agility, gait velocity, and cardiorespiratory fitness (5,6). It is reported that both sedentary lifestyle and lower physical fitness result in spending more effort to perform normal daily activities and increase falling risk (7).…”

“…The effectiveness of physical activity and fitness programs has been researched in studies about management of falling risk and FOF (3,7,8). It seems that beside physical inactivity, lower physical fitness contributes to falling risk and FOF.…”

Accelerometer‐Measured Moderate to Vigorous Physical Activity and Incidence Rates of Falls in Older Women

“…26 The results of this observational study support no association of higher levels of MVPA with fall risk in community-dwelling ambulatory women. Consistent with the present study, the ActiFE-Ulm Study, conducted in Southern Germany among 1214 older adults, found no increased risk of falls among older men or women with higher levels of accelerometer-measured PA. 30 …”

Sociotechnical probabilistic risk modeling to predict injurious falls in community living centers

“…For example, prospective and case-control studies have indicated that there is a 20 to 40 percent reduction in hip fractures in persons who engaged in physical activity compared with persons who were sedentary [1,11]. In a cohort study with a 1 yr follow-up, Klenk et al studied the relationship between physical activity and falls in 1,214 persons aged 65 yr and older who resided in the community [12]. These researchers found that there was a significant association between falls per 100 h walked and between falls and low activity, but no significant association between falls and average daily physical activity.…”