Abstract
The aim of the current study was to provide new evidence for the associations between physical activity (PA), sedentary behavior (SB), and fear of falling (FOF) by investigating the impact of replacing 30 min SB with both light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA) on FOF in older Chinese women. Cross-sectional data from a Physical Activity and Health in Older Women Study (PAHIOWS) were analyzed for 1114 Chinese community-dwelling older women. Variables of focus were demographics, FOF, objectively measured PA and SB. Three different logistic models were used to examine the associations between PA, SB, and FOF (a single parameter model, a partition model and an isotemporal substitution). The results showed that reallocating 30 min/day of MVPA by SB was significantly associated with higher FOF (OR = 1.37; 95%CI: 1.04–1.79; p = 0.024), reallocating 30 min/day of SB by MVPA was significantly associated with a reduction of FOF (OR = 0.73; 95%CI: 0.56–0.96; p = 0.024). No significant associations were found between FOF with reallocating other activities by LPA and vice versa (p > 0.05). Subgroup analysis showed the isotemporal-substituted effects of MVPA and SB on FOF were stronger in older women with fall experience. In conclusion, the current findings showed that the increase of MVPA engagement and reduction of SB engagement may be most beneficial for FOF management and should be involved in public health guidelines, especially for older women with fall experience.
Highlights
Published: 3 March 2022Fear of falling (FOF), which was defined as low perceived self-efficacy and confidence at avoiding falls during essential, nonhazardous activities of daily living [1], has been clearly regarded as one of the most important and potentially modifiable threats to autonomy in older adults [2]
Significant differences were observed between low fear of falling (FOF) group and high FOF group in age, education status, fall experience, nutritional status, BMI, balance ability, and moderate-to-vigorous PA (MVPA) time
Isotemporal substitution showed that reallocating 30 min/day of MVPA by sedentary behavior (SB) was significantly associated with higher FOF (OR = 1.37; 95%confidence intervals (CIs): 1.04–1.79; p = 0.024)
Summary
Published: 3 March 2022Fear of falling (FOF), which was defined as low perceived self-efficacy and confidence at avoiding falls during essential, nonhazardous activities of daily living [1], has been clearly regarded as one of the most important and potentially modifiable threats to autonomy in older adults [2]. FOF is a contributor to many adverse health outcome, such as decreasing physical function, more frequent falls, more severe frail and rising mortality, especially in older women [3–6]. A prospective study of older adults identified that a sedentary or physically inactive lifestyle was a potential and vital predisposing factor for FOF [7]. Physical activity (PA) and sedentary behavior (SB) are independent determinants and major modifiable factors of many chronic diseases [8,9]. Both the 2020 Global Recommendations on PA and SB for Health updated by the World Health Organization and the PA. Limited studies have investigated the associations between PA, SB lifestyle, and FOF severity while the inconsistent conclusions were constrained by PA and SB measurement methods, adjustment of confounding factors, as well as sample characteristics [12–15]
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