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

in Journal of Aging and Physical Activity

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Benjamin T. SchumacherHerbert Wertheim School of Public Health and Longevity Science, UC San Diego School of Medicine, San Diego, CA, USA

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John BellettiereHerbert Wertheim School of Public Health and Longevity Science, UC San Diego School of Medicine, San Diego, CA, USA

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Michael J. LaMonteDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo–SUNY, Buffalo, NY, USA

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Kelly R. EvensonDepartment of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

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Chongzhi DiPublic Health Sciences Division, The Fred Hutchinson Cancer Research Center, Seattle, WA, USA

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I-Min LeeBrigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

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David A. SleetDivision of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA

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Charles B. EatonDepartment of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, RI, USA

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Cora E. LewisDepartment of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USA

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Karen L. MargolisHealthPartners Institute for Medical Education, Minneapolis, MN, USA

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Lesley F. TinkerThe Fred Hutchinson Cancer Research Center, Seattle, WA, USA

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Andrea Z. LaCroixHerbert Wertheim School of Public Health and Longevity Science, UC San Diego School of Medicine, San Diego, CA, USA

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DOI:
https://doi.org/10.1123/japa.2021-0159
Keywords:
epidemiology; incident falls; older adults
First Published Online:
09 Oct 2021
In Print:
Volume 30: Issue 4
Page Range:
635–645
Restricted access

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.

Schumacher (btschuma@health.ucsd.edu) is corresponding author.

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