This study examined the association between physical activity, physical function, and risk of falls over six years among older Mexican Americans. The researchers found that those with high physical activity but low physical function had a lower risk of falls, but the risk increased over time. Those with high levels of both physical activity and function also had a lower initial risk, but it increased over time as well. The study concludes that interventions for older adults should focus on improving physical function rather than just overall activity to help prevent falls.

1. Discussion
• Our findings support previous evidence that physical activity
frequency results in an increased risk of falls
• The most present physical activities were lifestyle activities and
not ones that improve physical function (muscle strengthening
and balance)
• Thoughtful considerations must be made in prescribing physical
activity in this population:
• In-home exercises
• Environmental modifications
• Functional exercises
Methods
• Studied a sub-sample of participants from the Hispanic
Established Population for the Epidemiologic Study of the
Elderly (H-EPESE)
• Baseline data was collected in 2004-2005 and follow-up
assessments were in 2007-2008, 2010-2011
• Physical activity was measured by the Physical Activity Scale
for the Elderly (PASE) and physical function was measured by
the Short Physical Performance Battery (SPPB)
• Participants were divided in categories: low physical activity
(LPA)- low physical function (LPF); LPA- high physical function
(HPF); high physical activity (HPA)- LPF; HPA-HPF
• Falls were measured through self-report from 12-month recall
• Covariates included: age, sex, years of formal education,
martial status, body mass index (BMI), Center for Epidemiologic
Studies Depression Scale, Mini Mental State Examination
(MMSE), near and distance vision impairment, comorbidities
(stroke, heart attack, cancer, Parkinson’s disease,
hypertension, diabetes, fracture, emphysema, arthritis)
The Role of Physical Activity and Physical Function on the Risk of Falls in Older Mexican Americans
Zakkoyya H. Lewis BS1,2
, Kyriakos S. Markides PhD1,3
, Kenneth Ottenbacher PhD1,2
, Soham Al Snih MD, PhD1,2
1
Department of Preventive Medicine and Community Health 2
Division of Rehabilitation Sciences/School of Health
Professions 3
Division of Sociomedical Sciences, Department of Preventive Medicine and Community Health, UTMB
Descriptive CharacteristicsBackground
• Falls among older adults is a public health concern
• A multifactorial intervention is recommended to prevent falls but
exercise alone is highly effective and strongly recommended
• Physical activity may prevent falls from improved physical
function
• The purpose of our study was to investigate the
association between physical activity and physical
function levels, on the risk of falls over six-year
period among older Mexican Americans.
References
This work was supported by the National
Institute of Health/National Institute on Aging
(R01 AG10939, R01 AG17638, P30 AG024832)
and by the National Institute for Child Health
and Human Development (R24 HD065702).
Conclusion
• Final sample, n=1011 (LPA-LPF: n=453; LPA-HPF: n=54; HPA-
LPF: n=307; HPA-HPF: n=197)
• Baseline characteristics: 82.3±4.6years of age, 4.9±3.9 years of
education, 27.4±5.0 kg/m2
BMI, 2.1±1.2 comorbidities (67.3%
hypertension, 63.1% arthritis, 35.0% diabetes), 63.2% female,
41.7% married, 36.4% reported previous fall
• Mean PASE score was 77.2±61.4 and mean SPPB was 5.6±3.6
• Most prevalent physical activities were light housework (73.5%),
walking outside (50.5%), and outdoor gardening (50.0%)
• Among those with no falls at baseline 41% had at least one fall,
17% did not fall, 23% died, and 19% were lost to follow up
1. Guideline for the prevention of falls in older persons. American Geriatrics Society, British
Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J
Am Geriatr Soc. 2001;49(5):664-672.
2. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults:
recommendation from the American College of Sports Medicine and the American Heart
Association. Med Sci Sports Exerc. 2007;39(8):1435-1445.
3. Michael Y, Lin J, Whitlock E, et al. Interventions to Prevent Falls in Older Adults: An Updated
Systematic Review. Evidence Synthesis No. 80. AHRQ Publication No. 11-05150-EF-1. Rockville,
MD: Agency for Healthcare Research and Quality; December 2010.
General Estimation Equations for Falls over 6-year of Follow-Up
Variable Model 1 Model 2
OR (95% Confidence Interval)
Main Effect Time Interaction Main Effect Time Interaction
LPA-LPF Ref Ref Ref Ref
LPA-HPF 1.22 (0.24-6.92) 0.79 (0.44-1.41) 1.19 (0.16-8.69) 0.76 (0.37-1.52)
HPA-LPF 0.34 (0.14-0.80)* 1.41 (1.08-1.89) ‡ 0.39 (0.14-0.99)* 1.38 (1.01-1.90)*
HPA-HPF 0.35 (0.14-0.91)* 1.41 (1.05-1.89)* 0.60 (0.21-1.74) 1.20 (0.85-1.68)
Time 1.06 (0.88-1.27) - 1.08 (0.87-1.35) -
*p<0.05, ‡p<0.01; OR- Odds Ratio; Model 1 included time, age, gender, marital status, education, falls
at baseline, and physical ability groups.; Model 2 included BMI, depressive symptoms, MMSE, and
comorbidities along with variables in Model 1.
• Current guidelines recommend physical activities but our results
suggest that high levels of physical activity are associated with
an increased number of falls among older Mexican American
adults
• Increasing activities that improve physical function, instead of
increasing overall physical activity, should be the focus in order
to prevent falls within this population.
Results
LPA-LPF: Low physical activity- Low physical function; LPA-HPF: Low physical
activity- High physical function; HPA-LPF: High physical activity- Low physical
function; HPA-HPF: High physical activity- High physical function.