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. 2021 Oct 9;30(4):635-645.
doi: 10.1123/japa.2021-0159. Print 2022 Aug 1.

Accelerometer-Measured Daily Steps, Physical Function, and Subsequent Fall Risk in Older Women: The Objective Physical Activity and Cardiovascular Disease in Older Women Study

Benjamin T Schumacher  1 , John Bellettiere  1 , Michael J LaMonte  2 , Kelly R Evenson  3 , Chongzhi Di  4 , I-Min Lee  5 , David A Sleet  6 , Charles B Eaton  7 , Cora E Lewis  8 , Karen L Margolis  9 , Lesley F Tinker  10 , Andrea Z LaCroix  1
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Accelerometer-Measured Daily Steps, Physical Function, and Subsequent Fall Risk in Older Women: The Objective Physical Activity and Cardiovascular Disease in Older Women Study

Benjamin T Schumacher et al. J Aging Phys Act. .

Abstract

Steps per day were measured by accelerometer for 7 days among 5,545 women aged 63-97 years between 2012 and 2014. Incident falls were ascertained from daily fall calendars for 13 months. Median steps per day were 3,216. There were 5,473 falls recorded over 61,564 fall calendar-months. The adjusted incidence rate ratio comparing women in the highest versus lowest step quartiles was 0.71 (95% confidence interval [0.54, 0.95]; ptrend across quartiles = .01). After further adjustment for physical function using the Short Physical Performance Battery, the incidence rate ratio was 0.86 ([0.64, 1.16]; ptrend = .27). Mediation analysis estimated that 63.7% of the association may be mediated by physical function (p = .03). In conclusion, higher steps per day were related to lower incident falls primarily through their beneficial association with physical functioning. Interventions that improve physical function, including those that involve stepping, could reduce falls in older adults.

Keywords: epidemiology; incident falls; older adults.

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Figures

Figure 1.
Figure 1.
Dose-Response Trajectories of Incident Fall Risk by Level of the Short Physical Performance Battery SPPB = Short Physical Performance Battery. Associations are adjusted for age, race/ethnicity, education, vision, body pain, alcohol use, sleep aid use, body mass index, and the number of chronic conditions. SPPB scores range from 0 (lowest functioning) – 12 (highest functioning). Dots are at the 25th, 50th, and 75th percentile of the SPPB-specific step distribution. The highlighted portion represents the 5th to the 95th percentile of each stratum’s step distribution. Interaction P-value from the corresponding parametric model.
Figure 2.
Figure 2.
Dose-Response Trajectories of Incident Fall Risk by Fall History (A) and Age Tertiles (B) Adjusting for Levels of the Short Physical Performance Battery Associations are adjusted for age, race/ethnicity, education, vision, body pain, alcohol use, sleep aid use, body mass index, number of chronic conditions, and the Short Physical Performance Battery. Dots are at the 25th, 50th, and 75th percentile of the strata-specific step distribution. The highlighted portion represents the 5th to the 95th percentile of each stratum’s step distribution. Interaction P-values from the corresponding parametric model.
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