Incident Fall Risk and Physical Activity and Physical Performance among Older Men: The Osteoporotic Fractures in Men Study

Abstract

Physical activity and physical performance have been linked to fall risk in the elderly. The authors examined the relation between physical activity and physical performance with incident falls in the Osteoporotic Fractures in Men Study, a large prospective cohort study of 5,995 community-dwelling men in the United States at least 65 years of age. The authors also examined what types of activities are associated with falling. Incident falls between 2000 and 2005 were captured from up to 17 triannual follow-up questionnaires per participant and analyzed with generalized estimating equations. Follow-up averaged 4.5 years. The average risk of falling in the first 4 months of follow-up was 6.6%. The most active quartile had a significantly greater fall risk than did the least active quartile (relative risk = 1.18, 95% confidence interval (CI): 1.07, 1.29). Men with greater leg power and grip strength had significantly reduced fall risk (for highest leg power quartile vs. lowest: relative risk = 0.82, 95% CI: 0.73, 0.92; for highest grip strength quartile vs. lowest: relative risk = 0.76, 95% CI: 0.69, 0.85). Partitioning components of activity showed no association between fall risk and leisure activities but a positive association with household activities (for highest quartile vs.lowest: relative risk = 1.17, 95% CI: 1.07, 1.28).

Fall-related factors among less and more active older outpatients

“…Both high and low levels of physical activity have been associated with increased fall risk in older adults, but a U-shaped relationship could not be proven [8][9][10] . The relationship between falling and physical activity level is complex and can be influenced by many factors, including perceived and objective physical functioning capacity, activity type and intensity, risky behaviors, and environmental circumstances [11][12][13] .…”

“…It is assumed that active older adults have more confidence in their balance and skills in avoiding falls. In fact, men with higher physical activity levels, even those with good leg strength, have increased fall risk 8 and, among people with good physical abilities, the risk of recurrent falling was higher in those who participated in high-intensity activities 11 .…”

May the Power Be With Us

“…In men with lower extensor muscle power in the lower extremities, a higher frequency of falls was observed within the 4 months before testing [31]. In another study, compared to persons who had not experienced a fall, elderly people who had experienced falls demonstrated 85% strength in the lower extremities (isometric, concentric and eccentric strength), and only 79% power, measured during bilateral lower extremity extension [32].…”

The Effect of Exercise on Bone Mineral Density, Bone Markers and Postural Stability in Subjects with Osteoporosis

“…Intrinsic factors are conditions that relate directly to a specific person such as dizziness, use of medication, osteoporosis, and arthritis (Hale et al, 1992). A comprehensive prospective study concerning the risks associated with falls in older men was performed by Chan et al (2007). They found that leg extension power, grip strength, and activity level are significant determinants in assessing the risk of fall.…”