Can Physical Activity and Functional Fitness Discriminate Fallers in Older Adults?

Abstract

Reduced physical activity (PA) is common in the elderly. It has been shown1 that maintaining a relatively high level of PA is associated with a decrease in fall prevalence (FP). This may be explained by the fact that older adults who remain physically active maintain functional fitness (FF) levels required to counteract postural imbalance that leads to falls. Studies have been done to determine the prediction level of different PF tests in discriminating PA, PF and FP levels. PURPOSE: The purpose of this study was to verify if FF and PA (level and intensity) can discriminate fallers in older adults. METHODS: A cross-sectional study was designed to determine FP, PA and FF. 155 older adults (74±8.1 y) volunteered to participate in the study. FP, assessed using a fall questionnaire designed for this purpose, allowed a sample division in non-fallers, fallers (1 fall) and recurrent fallers (≥2 falls). To assess PA level (daily total amount) and intensity, data from biaxial accelerometers (Actigraph Model 7164) was collected during 3 consecutive days. FF was assessed with the tests 8 feet up and go (UG) and 30sec Chair-Stand (CS) 3, and the total balance score (BS) obtained with items 1, 4, 5 and 7 of FAB Scale2. Trained examiners administered the questionnaire and PF tests. Mann-Whitney test (SPSS 17) was used to detect differences between non-fallers, fallers and recurrent fallers. RESULTS: For all the FF tests significant statistical differences were found between non-fallers and fallers (CS: -2.506, p=.012; UG: -3.232, p=.001; BS:-2.914; p=.004). When comparing non-fallers and recurrent fallers, it seems that PF (CS:-3.500, p=.000; UG:-4.143, p=.000; BS:-4.074, p=.000), PA level (-2.190, p=.029) and PA intensity (L:-2.553, p=.011; V:-2.575, p=.010) have a preventive role in FP. Finally vigorous PA seems to be the only differentiate factor between fallers and recurrent fallers (-2.460, p=.014). CONCLUSIONS: Agreeing with the literature, all FF tests seem to be good fall predictors. Besides that, the results seem to emphasize the need of assessing not only the PA level but also its intensity, when trying to discriminate fallers in older adults. REFERENCES:1 Daley, M et al. (2000). Sports Med, 29., 2Hernandez, D. et al. (2008) Arch of Phys Med &Rehab, 89(12), 2309-2315., 3 Jones, C. J. et al. (1999). Res Q Exerc Sport, 70(2), 113-119.