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Journal of the American Geriatrics Society Research Summary

Experiencing a fall is one of the most common accidents older adults face: Each year, one-third of people over the age of 65 will fall. Half of these falls cause injuries, including serious ones such as hip fractures and others that require hospitalization.

Researchers have shown that higher levels of physical activity can reduce your risk for a fall. Although you might think that being inactive, or sedentary, is safer for you than being active, it actually contributes to falling.

Common sedentary behaviors include sitting while watching television, using a computer, or riding in a car. To reduce sedentary time, you can use a standing desk, and try devices that remind you when it’s time to get up and move around a bit.

Older adults who are mostly sedentary are likely to suffer poor physical function and other signs of ill health, but we don’t have much research about how sedentary time contributes to your risk for falls. In theory, being sedentary could lead to weakness or loss of stability in your legs and hips, could harm the interaction of your nerves and muscles, or lessen your strength and balance — all of which can lead to falls.

On the other hand, people who are more sedentary may be less likely to fall.

It’s difficult to know whether being sedentary affects the likelihood of falling, partly because measuring sedentary time is difficult. We do know that older adults who report being sedentary have an increased risk for falling. However, they may have difficulty remembering the amount of time they’ve spent being sedentary.

In a new study, published in the Journal of the American Geriatrics Society, researchers used devices to monitor active and sedentary time. They examined links between device-measured sedentary time and the number of falls experienced. The researchers also examined whether these associations varied, based on a person’s moderate-to-vigorous physical activity, physical function, and history of falling. Finally, the researchers outlined the participants’ fall-related injuries and hospitalizations by their sedentary time.

To learn more about the relationship between sedentary time and falls, researchers analyzed information collected from women who were enrolled in the Objective Physical Activity and Cardiovascular Disease Health (OPACH) Study, part of the Women’s Health Initiative (WHI) Long Life Study. In the WHI study, postmenopausal women aged 50 to 79 years were enrolled and completed baseline assessments between 1993 and 1998.

Participants in the OPACH study took a home test which measured their ability to walk, stand, and get up from a chair, and they answered questions about their health. Just over 7,000 women participated between March 2012 and April 2014.

Researchers asked participants to wear accelerometers — devices similar to fitness trackers that monitor and measure movement — for seven days, except during bathing or swimming. People who wore the devices for 10 or more hours on at least four days were included in the study.

The participants recorded any falls on special calendars for up to 13 months after they wore the monitors for several days. Participants were instructed to record daily whether they had a fall. Calendar pages were mailed back to study researchers each month. Researchers interviewed some of the participants who reported falls by telephone about events that led to the fall, the location of the fall, and whether injuries occurred.

Overall, 5,980 falls were reported from the calendars, and 1,492 women completed interviews regarding 3,375 falls.

The women studied were in their 70s or 80s; 51 percent were white, 33 percent African American, and 17 percent Hispanic. Women who logged the most sedentary time were more likely to be older, white and non-drinkers, report poor balance and vision, and have severe body pain, higher ratios of body weight to height, more chronic conditions, and more falls in the previous year.

Women who were on average sedentary for longer periods of time had an increased risk for falling. Also, for women with a history of two or more falls, more sedentary time was associated with an increased risk for falls.

Falls experienced by women who had the least amount of sedentary time were the least likely to require medical treatment and also the least likely to experience a serious injury or fracture.

The researchers concluded that the more time older women spent being sedentary, the more falls they experienced over 13 months. According to the researchers, these are the first findings to link sedentary time to a higher incidence of falls.

This summary is from “Accelerometer-measured sedentary patterns are associated with incident falls in older women.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are: Dori E. Rosenberg, PhD, MPH; Eileen Rillamas-Sun, PhD, MPH; John Bellettiere, PhD; Michael LaMonte, PhD; David M. Buchner, MD, MPH; Chongzhi Di, PhD; Julie Hunt, PhD; Stephen Marshall, PhD; Marcia Stefanick, PhD; Yuzheng Zhang, MS; and Andrea Z. LaCroix, PhD.

 

 



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