Falls and physical inactivity increase with age. However, physical activity, falls and their associations in older people born at different times are unclear. Women born 1921-26 and 1946-51 who completed follow-up questionnaires in 1999 (n = 8403, mean (SD) age: 75 (1) years) and 2019 (n = 7555; 71 (1) years) in the Australian Longitudinal Study on Women's Health. Self-reported noninjurious and injurious falls in the previous 12 months and weekly amounts and types of physical activity (brisk walking, moderate- and vigorous-intensity) were compared between the cohorts using Chi-square tests. Associations between physical activity, and noninjurious and injurious falls were estimated using multinomial logistic regressions informed by a directed acyclic graph. A greater proportion of the later (1946-51) cohort (59%) reached 150-300 minutes of weekly physical activity, as recommended by the World Health Organization, compared to the earlier (1921-26) cohort (43%, p < .001). A greater proportion of the later cohort reported noninjurious falls (14% vs 8%). Both cohorts reported similar proportions of injurious falls (1946-51:15%, 1921-26:14%). In both cohorts, participation in 150-300 minutes of physical activity was associated with lower odds of noninjurious falls (adjusted Odds Ratio, 95% CI: 1921-26: 0.66, 0.52-0.84; 1946-51: 0.78, 0.63-0.97) and injurious falls (1921-26: 0.72, 0.60-0.87; 1946-51: 0.78, 0.64-0.96). Participation in recommended levels of physical activity was associated with reduced falls in both cohorts. However, generational differences were found with more falls and more physical activities in the women born later. Future studies could examine the reasons contributing to the generational differences.
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