Am J Prev Med. 2015 Dec;49(6):888-901. doi: 10.1016/j.amepre.2015.05.022. Epub 2015 Jul 29.

Leisure-Time Physical Activity, Falls, and Fall Injuries in Middle-Aged Adults.

Caban-Martinez AJ¹, Courtney TK², Chang WR³, Lombardi DA², Huang YH⁴, Brennan MJ⁵, Perry MJ⁶, Katz JN⁷, Christiani DC⁸, Verma SK⁹.

Author information

1: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
2: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
3: Center for Physical Ergonomics, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.
4: Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.
5: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.
6: Department of Environmental and Occupational Health, The George Washington University, Washington, District of Columbia;
7: Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
8: Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
9: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: santosh.verma@libertymutual.com.

Abstract

INTRODUCTION:

Although exercise and strength training have been shown to be protective against falls in older adults (aged 65 years and older), evidence for the role of leisure-time physical activity (LTPA) in the prevention of falls and resulting injuries in middle-aged adults (aged 45-64 years) is lacking. In the present study, we investigate the association between self-reported engagement in LTPA and the frequency of falls and fall-related injuries among middle-aged and older adults, while controlling for key sociodemographic and health characteristics.

METHODS:

Nationally representative data from the 2010 U.S. Behavioral Risk Factor Surveillance Survey were analyzed in April 2014 to examine the number of adults aged ≥45 years who self-reported their fall experience in the previous 3 months and any injuries that resulted from those falls. We then evaluated the association between LTPA and self-reported falls and injuries across three age strata (45-54, 55-64, and ≥65 years). The two main self-reported outcome measures were (1) frequency of falls in the 3 months prior to the survey interview date and (2) the number of injuries resulting from these falls. Prevalence ratios (PRs) and 95% CIs were calculated using Poisson regression models with robust SEs.

RESULTS:

Of 340,680 survey participants aged ≥45 years, 70.7% reported engaging in LTPA, and 17% reported one or more falls. Among those reporting a fall within 3 months, 25.6% experienced one injurious fall (fall resulting in an injury) and 8.4% reported two or more injurious falls. Controlling for sociodemographic and health characteristics, among adults aged 45-54 years, those who engaged in LTPA were significantly less likely to report one fall (PR=0.90, 95% CI=0.81, 0.99); two or more falls (PR=0.84, 95% CI=0.77, 0.93); one injurious fall (PR=0.88, 95% CI=0.78, 0.99); and two or more injurious falls (PR=0.69, 95% CI=0.58, 0.83) than those who did not exercise. A similar protective effect of LTPA on reporting falls and injuries was noted for adults aged 55-64 and ≥65 years.

CONCLUSIONS:

Similar to older adults, middle-aged adults who engage in LTPA report fewer falls and fall-related injuries. Upon further confirmation of the relationship between LTPA and falls among middle-aged adults, fall prevention interventions could be developed for this population.