Lifestyle predicts falls independent of physical risk factors

K. A. Faulkner, J. A. Cauley, S. A. Studenski, D. P. Landsittel, S. R. Cummings, K. E. Ensrud, M. G. Donaldson, M. C. Nevitt

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63 Scopus citations


Many falls occur among older adults with no traditional risk factors. We examined potential independent effects of lifestyle on fall risk. Not smoking and going outdoors frequently or infrequently were independently associated with more falls, indicating lifestyle-related behavioral and environmental risk factors are important causes of falls in older women. Introduction: Physical and lifestyle risk factors for falls and population attributable risks (PAR) were examined. Methods: We conducted a 4-year prospective study of 8,378 community-dwelling women (mean age=71 years, SD=3) enrolled in the Study of Osteoporotic Fractures. Data on number of falls were self-reported every 4 months. Fall rates were calculated (# falls/woman-years). Poisson regression was used to estimate relative risks (RR). Results: Physical risk factors (p≤0.05 for all) included tall height (RR = 0.89 per 5 in.), dizziness (RR=1.16), fear of falling (RR=1.20), self-reported health decline (RR=1.19), difficulty with Instrumental Activities of Daily Living (IADLs) (RR=1.12, per item), fast usual-paced walking speed (RR=1.18, per 2 SD), and use of antidepressants (RR=1.20), benzodiazepines (RR=1.11), or anticonvulsants (RR=1.62). Protective physical factors (p≤0.05 for all) included good visual acuity (RR=0.87, per 2 SD) and good balance (RR=0.85 vs. poor). Lifestyle predicted fewer falls including current smoking (RR=0.76), going outdoors at least twice weekly but not more than once a day (RR=0.89 and vs. twice daily). High physical activity was associated with more falls but only among IADL impaired women. Five potentially modifiable physical risk factors had PAR≥5%. Conclusions: Fall interventions addressing modifiable physical risk factors with PAR≥5% while considering environmental/behavioral risk factors are indicated.

Original languageEnglish (US)
Pages (from-to)2025-2034
Number of pages10
JournalOsteoporosis International
Issue number12
StatePublished - Dec 2009

Bibliographical note

Funding Information:
This study received funding through these grant numbers: AG05407, AR35582, AG027576-22, AG05394, AG005394-22A1, AR35584, AR35583, AG027574-22A1, and P30 AG024827.


  • Behavioral risk factors
  • Fall rates
  • Falls
  • Lifestyle
  • Physical risk factors
  • Risk factors


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