The Relationships between Physical Performance, Activity Levels, and Falls in Older Men

Eric S. Orwoll, Nora F. Fino, Thomas M. Gill, Jane A. Cauley, Elsa S. Strotmeyer, Kristine E. Ensrud, Deborah M. Kado, Elizabeth Barrett-Connor, Douglas C. Bauer, Peggy M. Cawthon, Jodi Lapidus, Anne Newman

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background: Physical performance and activity have both been linked to fall risk, but the way they are jointly associated with falls is unclear. We investigated how these two factors are related to incident falls in older men. Methods: In 2,741 men (78.8 ± 5 years), we evaluated the associations between activity and physical performance and how they jointly contributed to incident falls. Activity was assessed by accelerometry. Physical performance was measured by gait speed, dynamic balance (narrow walk), chair stand time, grip strength, and leg power. Falls were ascertained by tri-annual questionnaires. Results: Men were grouped into four categories based on activity and performance levels. The greatest number of falls (36%-43%) and the highest fall rate (4.7-5.4/y among those who fell) (depending on the performance test) occurred in men with low activity/low performance, but most falls (57%-64%) and relatively high fall rates (3.0-4.35/y) occurred in the other groups (low activity/high performance, high activity/high performance and high activity/low performance; 70% of men were in these groups). There were interactions between activity, performance (gait speed, narrow walk), and incident falls (p =. 001-.02); predicted falls per year were highest in men with low activity/low performance, but there was also a peak of predicted falls in those with high activity. Conclusions: In community-dwelling older men, many falls occur in those with the lowest activity/worst physical performance but fall risk is also substantial with better activity and performance. Activity/physical performance assessments may improve identification of older men at risk of falls, and allow individualized approaches to prevention.

Original languageEnglish (US)
Pages (from-to)1475-1483
Number of pages9
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number9
StatePublished - Aug 16 2019

Bibliographical note

Funding Information:
E.S.O. receives grant support from Merck and Lilly unrelated to this project. P.M.C. receives grant support from GSK unrelated to this project. The other authors have no conflicts.

Funding Information:
This work was supported by National Institutes of Health. The Osteoporotic Fractures in Men (MrOS) Study was supported by the National Institute on Aging; the National Institute of Arthritis and Musculoskeletal and Skin Diseases; the National Center for Advancing Translational Sciences; the National Institutes of Health Roadmap for Medical Research (grant numbers U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128); an Academic Leadership Award from the National Institute on Aging (grant number K07 AG043587) (to T.M.G.); and the Claude D. Pepper Older Americans Independence Center (grant number P30 AG021342) (to T.M.G.).

Publisher Copyright:
© 2018 The Author(s). Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.


  • Activity
  • Aging
  • Function
  • Observational


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