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Objectively Measured Physical Activity and Falls in Well-Functioning Older Adults: Findings From the Baltimore Longitudinal Study of Aging

Nastasi, Anthony, J., MHS; Ahuja, Alka, MS; Zipunnikov, Vadim, PhD; Simonsick, Eleanor, M., PhD; Ferrucci, Luigi, MD, PhD; Schrack, Jennifer, A., PhD, MS

American Journal of Physical Medicine & Rehabilitation: April 2018 - Volume 97 - Issue 4 - p 255–260
doi: 10.1097/PHM.0000000000000830
Original Research Articles
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Objective Previous work demonstrates the consequences of falling in older adults and the potential of physical activity (PA) to reduce falls, but few studies have used accelerometer-measured PA to compare overall and time-of-day activity patterns of nonfallers, fallers, or subgroups of fallers.

Methods In 840 participants (mean age, 66.7; s = 13.2; range, 26–97) of the Baltimore Longitudinal Study of Aging between 2007 and 2014, PA was measured objectively with Actiheart accelerometers and falling status (faller/nonfaller) was assessed during an in-person interview. Differences in daily PA and PA by time-of-day were assessed using multiple linear regression. Differences in PA (multiple linear regression), and functional status (χ2) were further examined in subgroups of “risky” or “normal” fallers.

Results Overall, fallers and nonfallers exhibited similar daily (β = 22.6, P = 0.48) and time-specific PA; however, those who fell doing risky activities were more active overall (β = 243.8, P = 0.002), during the morning (β = 77.3, P = 0.004), afternoon (β = 78.4, P = 0.001), and late afternoon/evening (β = 56.3, P = 0.006) than those who fell doing normal activities. Risky fallers were significantly higher functioning than normal fallers.

Conclusions Persons who fell while engaging in normal activities exhibited lower PA overall and throughout most of the day, and were of lower functional status than persons who fell while engaging in risky or unusual activities, suggesting that engagement in risky or unusual PA is associated with higher functional ability and lower falls risk in older persons.

From the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (AJN, AA, VZ, JAS); Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland (AJN); and National Institute of Aging, Baltimore, Maryland (EMS, LF).

All correspondence should be addressed to: Anthony J. Nastasi, MHS, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205.

This work was presented at the Johns Hopkins 3rd Annual Research on Aging Showcase, winning 3rd place.

This work was supported by the Intramural Research Program of the NIH, National Institute on Aging. Data for these analyses were obtained from the Baltimore Longitudinal Study of Aging, an ongoing study of normative aging conducted by the National Institute on Aging.

Anthony Nastasi contributed in the study design, analysis, interpretation of data, and preparation of manuscript.

Alka Ahuja also worked on the analysis, interpretation of data, and preparation of manuscript.

Vadim Zippunikov contributed as well with the analysis, interpretation of data, preparation of manuscript.

Eleanor Simonsick worked on the interpretation of data, preparation of manuscript.

Luigi Ferrucci also worked on the interpretation of data, preparation of manuscript.

Jennifer Schrack was responsible for data acquisition and also worked on the study design, analysis, interpretation of data, and preparation of manuscript.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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