title: Positive components of mental health provide significant protection against likelihood of falling in older women over a 13-year period.
abstract: BACKGROUND
  In late life, falls are associated with disability, increased health service utilization and mortality. Physical and psychological risk factors of falls include falls history, grip strength, sedative use, stroke, cognitive impairment, and mental ill-health. Less understood is the role of positive psychological well-being components. This study investigated the protective effect of vitality on the likelihood of falls in comparison to mental and physical health.
  
  
  METHODS
  Female participants were drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) harmonization project. Participants (n = 11,340) were aged 55-95 years (Mean = 73.68; SD = 4.31) at baseline and observed on up to four occasions for up to 13 years (Mean = 5.30; SD = 2.53).
  
  
  RESULTS
  A series of random intercept logistic regression models consistently identified vitality's protective effects on falls as a stronger effect in the reduction of the likelihood of falls than the effect of mental health. Vitality is a significant predictor of falls likelihood even after adjusting for physical health, although the size of effect is substantially explained by its covariance with mental and physical heath.
  
  
  CONCLUSIONS
  Vitality has significant protective effects on the likelihood of falls. In comparison with mental health, vitality reported much stronger protective effects on the likelihood to fall in comparison with the risk associated with poor mental health in a large sample of older female adults. Both physical health and mental health account for much of the variance in vitality, but vitality still reports a protective effect on the likelihood of falls.
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia. Richard.Burns@anu.edu.au
authors.forename: Richard A
authors.initials: RA
authors.lastname: Burns
authors.forename: Julie
authors.initials: J
authors.lastname: Byles
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008603:Mental Health; D008875:Middle Aged; D012307:Risk Factors