title: Longitudinal association between habitual walking and fall occurrences among community-dwelling older adults: analyzing the different risks of falling.
abstract: The purpose of this longitudinal study was to examine the association between habitual walking and multiple or injurious falls (falls) among community-dwelling older adults, by considering the relative risk of falling. A cohort of Japanese community-dwelling older adults (n=535) aged 60-91 years (73.1±6.6 year, 157 men and 378 women) who underwent community-based health check-ups from 2008 to 2012 were followed until 2013. Incidence rate of falls between walkers and non-walkers was compared separately by the number of risk factors (Groups R0, R1, R2, R3 and R4+). The Cox proportional hazard model was used to assess the association between habitual walking and falls separately by lower- (R<2) and higher- (R≥2) risk groups. In Groups R0 and R1, the incidence of falls was lower in walkers than non-walkers; however, in Groups R2, R3, and R4+, the incidence of falls was higher in walkers. The Cox proportional hazard model showed that habitual walking was not significantly associated with falls (hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.48-1.62) among the lower risk group but that it was significantly associated with increased falls (HR: 1.89, 95% CI: 1.04-3.43) among the higher risk group. The significant interaction between habitual walking and higher risk of falling was found (P<0.05). When individuals have two or more risk factors for falling, caution is needed when recommending walking because walking can actually increase their risk of experiencing multiple or injurious falls.
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan; The Japan Society for the Promotion of Science, 8 Ichiban, Chiyoda, Tokyo, 102-8472, Japan. Electronic address: Yoshiro_okubo@yahoo.co.jp.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: The Japan Society for the Promotion of Science, 8 Ichiban, Chiyoda, Tokyo, 102-8472, Japan; Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo, 173-0015, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Seino
authors.affiliation: Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Yabushita
authors.affiliation: The Japan Society for the Promotion of Science, 8 Ichiban, Chiyoda, Tokyo, 102-8472, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Osuka
authors.affiliation: Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Songee
authors.initials: S
authors.lastname: Jung
authors.affiliation: The Japan Society for the Promotion of Science, 8 Ichiban, Chiyoda, Tokyo, 102-8472, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Nemoto
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.
authors.forename: Rafael
authors.initials: R
authors.lastname: Figueroa
authors.affiliation: Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Kiyoji
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D012307:Risk Factors; D012621:Seasons; D016138:Walking
keywords: Elderly; Falling; Risk; Walking