1. 90 Year Olds are Less Likely to Fall if they were Physically Active Two Decades Earlier: The 90+ Study
Dana Greenia RN MS1, Annlia Paganini-Hill PhD2, S. Ahmad Sajjadi MD PhD1,2, Claudia H. Kawas MD1,2,3, María M. Corrada ScD1,2
1Institute for Memory Impairments and Neurological Disorders 2Department of Neurology 3Department of Neurobiology & Behavior, University of California, Irvine
M 178
OBJECTIVE
To determine if physical activity at ages 60s to 70s is associated with risk of falling at age 90+.
To examine factors related to falls in the oldest- old, people age 90 and older.
DISCUSSION
Falls were extremely common (52%) in year olds with 1/3 having multiple falls.
Physical activity of 30 minutes or more at ages 60s to 70s was related to a lower risk of falling in people aged 90 and older, even in the presence of medical co-morbidities or taking into account the need of assistive devices.
Strengths: Long interval between assessment of activity and falls (average 24 years). Activity information was self-reported and collected at ages 60s to 70s. We were able to evaluate many risk factors.
Limitations: No information about physical activity during the interval between the LWCS questionnaire and The 90+ Study assessment. Findings are limited to people who survive to age 90 and beyond.
Regular physical activity throughout old age may be a good strategy to reduce falls in the oldest-old, a rapidly growing age group.
Participant Characteristics at the Baseline Visit of The 90+ Study
Characteristics
All subjects
(n = 1536)
Non-Fallers
(n = 737)
Fallers
(n = 799)
Mean (SD)
90+ Study visit
94.0 (3.1)
93.8 (3.1)
94.1 (3.0)
the LWCS
70.0 (4.8)
69.9 (4.8)
70.1 (4.8)
Yrs. between LWCS & 90+
23.9 (3.2)
24.0 (3.2)
N (%)
Women
1195 (78%)
571 (77%)
624 (78%)
> High school education
273 (18%)
129 (18%)
144 (18%)
Sheltered Living**
540 (35%)
226 (31%)
314 (40%)
Source of Fall Information*
Self-report vs. informant
882 (57%)
473 (64%)
409 (51%)
Medical History
Hypertension
748 (51%)
348 (50%)
400 (53%)
Heart Disease*
667 (45%)
299 (42%)
368 (47%)
TIA or stroke***
417 (29%)
160 (23%)
257 (35%)
Vision disease***
1180 (82%)
542 (78%)
638 (85%)
Depression***
280 (19%)
100 (14%)
180 (24%)
Dementia*
527 (36%)
234 (33%)
293 (39%)
Prescription Drugs
Hypnotics*
310 (26%)
133 (23%)
177 (29%)
Anti-psychotics*
83 (7%)
30 (5%)
153 (9%)
Anti-depressants***
205 (17%)
73 (13%)
132 (21%)
Assistive Devices***
None
Cane Only
Walker
Wheelchair
421 (28%)
156 (10%)
456 (30%)
482 (32%)
275 (38%)
81 (11%)
175 (24%)
198 (27%)
146 (19%)
75 (9%)
281 (36%)
284 (36%)
*p<0.05, **p<0.01, ***p<0.001
Frequency of Falls in the Previous Year
52% of people reported falls in the previous year
32% of people had repeated falls
BACKGROUND
The risk of falls increases with age. Although risk factors for falls in younger elderly have been well characterized, only limited information is available about falls in the oldest-old (people aged 90 years and older).
Association Between Physical Activity
and Odds of Falling (falls vs 0 falls)
2.0
METHODS
1,536 individuals aged 90 and older from The 90+ Study who were originally part of the Leisure World Cohort Study (LWCS), an epidemiological study of lifestyle practices in a retirement community.
Self-reported physical activity at ages 60s to 70s from the LWCS reported as none, 15 minutes, minutes, or 1+ hour/day.
Falls in the previous year (yes/no) and other factors known to be related to falls, reported by a participant or informant at the baseline assessment of The 90+ Study.
Logistic regression to examine association between earlier physical activity and odds of falling at age 90+, adjusted for comorbidities, use of assistive devices, and source of information.
Regular physical activity (30+ minutes/day) at ages 60s- 70s was associated with a 35-36% lower odds of falling in the previous year at age 90+
Association Between Physical Activity
and Odds of Repeated Falls (2+ falls vs. 0 falls)
2.0
ACKNOWLEDGEMENTS
Supported by NIA grant R01AG21055
The participants and staff of
Odds of falling was related to medical histories (heart disease, TIA/stroke, vision disease, depression, dementia), medication use (hypnotics, antipsychotics, anti- depressants), use of assistive devices, living situation, and source of fall information (self-report vs informant)
Falls were not related to age, sex, education, history of hypertension, use of ACE-inhibitors, or smoking (ever vs never)
Regular physical activity (30+ minutes/day) at ages 60s- 70s was also associated with a 41-45% lower odds of repeated falls in the previous year at age 90+