Physical Activity and Falls From Midlife: Patterns and Bidirectional Associations

The relationship between physical activity behavior and subsequent falls in adults from midlife to older age is unclear. Falls and fall-related injuries could lessen physical activity participation. This study examined patterns and bidirectional associations between physical activity and falls from midlife to older age.

In the Australian Longitudinal Study on Women's Health, women born 1946-1951 (n=11,759, mean age: 56 years at baseline in 2004) self-reported weekly physical activity amounts (0, 1-<150, 150-<300, ≥300 minutes/week) and noninjurious and injurious falls every 3 years between 2004 survey and 2019 survey. Bidirectional prospective 3-year associations between physical activity and falls were examined using generalized estimating equations to estimate ORs and 95% CIs, adjusting for directed acyclic graph-informed covariates. Analyses were conducted in 2023.

Participation in any amount of physical activity was associated with a reduced risk of injurious falls (OR_{1-<150 min=}0.87; 95% CI=0.80, 0.96; OR_{150-<300 min=}0.87; 95% CI= 0.79, 0.96; OR_{≥300 min=}0.85; 95% CI=0.78, 0.93) in the next 3 years, compared with women with no physical activity. Women who reported noninjurious falls had lower odds of undertaking ≥300 minutes/week of physical activity 3 years later (OR=0.84; 95% CI=0.77, 0.92), compared with women without falls. Women who reported injurious falls had lower odds of subsequently undertaking various amounts of physical activity (OR=0.83, 95% CI=0.75, 0.91 for 1-<150; OR=0.82, 95% CI=0.74, 0.90 for 150-<300; OR=0.83, 95% CI=0.76, 0.90 for ≥300 minutes/week).

The prospective bidirectional association between physical activity and falls supports addressing falls by promoting activity and highlighting the impact of injurious falls on reduced physical activity participation.