Associations of objectively measured physical activity and sedentary behaviour with fall-related outcomes in older adults: a systematic review - 14/09/21

Doi : 10.1016/j.rehab.2021.101571

Keenan A. Ramsey, BSPH ¹, Waner Zhou, BSc ², Anna G.M. Rojer, MD ¹, Esmee M. Reijnierse, PhD ^2,³, Andrea B. Maier, MD, PhD ^1,^2,^4,^⁎
¹ Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
² Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
³ Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
⁴ Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore

^⁎Corresponding Author: Prof. Andrea B. Maier, Department of Medicine and Aged Care, @Age, Department of Human Movement Sciences, Amsterdam Movement Science, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands, Telephone: +31 20 5982000Department of Medicine and Aged Care, @AgeDepartment of Human Movement SciencesAmsterdam Movement ScienceVrije Universiteit Amsterdamvan der Boechorststraat 7, 1081 BT Telephone: +31 20 5982000AmsterdamThe Netherlands

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Abstract

Background

: Higher physical activity (PA) and lower sedentary behaviour (SB) are associated with better muscle strength, balance, and functional ability, which are imperative for avoiding falls. This systematic review aimed to describe the association between objectively measured PA and SB with falls, fear of falling, and fractures.

Methods

: Six databases were searched from inception to July 21, 2020 for articles reporting the association of objectively measured PA/SB with falls, fear of falling, and/or fractures in community-dwelling older adults ≥60 years old. Results were synthesized in effect-direction heat maps and albatross plots expressed as Pearson's correlation coefficients (R).

Results

: A total of 43 articles were included, representing 27,629 (range 26 to 5,545) community-dwelling older adults (mean [SD] age 76.6 [8.4] years, 47% female). Longitudinal associations were reported in 13 articles and cross-sectional associations in 30. Falls were reported in 11 articles, fear of falling in 18 and fractures in 2. Higher PA and lower SB were associated with less fear of falling (median [interquartile range] Rs = steps: -0.214 [0.249; -0.148], total PA: -0.240 [0.267; -0.144], and moderate-to-vigorous PA: -0.180 [0.382; -0.121]), but these associations did not extend to falls or fractures, which showed inconsistent effect directions.

Conclusion

: Fear of falling is associated with less engagement in PA and more SB, thus indicating that it is a psychological barrier to an active lifestyle. Varying effect directions for associations between PA and SB with falls and fractures may provide evidence for non-linear associations and require further research considering details of the fall or fracture incident.