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

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.