title: Leisure-Time Physical Activity, Falls, and Fall Injuries in Middle-Aged Adults.
abstract: BACKGROUND
  Although exercise and strength training have been shown to be protective against falls in older adults (aged 65 years and older), evidence for the role of leisure-time physical activity (LTPA) in the prevention of falls and resulting injuries in middle-aged adults (aged 45-64 years) is lacking. In the present study, we investigate the association between self-reported engagement in LTPA and the frequency of falls and fall-related injuries among middle-aged and older adults, while controlling for key sociodemographic and health characteristics.
  
  
  METHODS
  Nationally representative data from the 2010 U.S. Behavioral Risk Factor Surveillance Survey were analyzed in April 2014 to examine the number of adults aged ≥45 years who self-reported their fall experience in the previous 3 months and any injuries that resulted from those falls. We then evaluated the association between LTPA and self-reported falls and injuries across three age strata (45-54, 55-64, and ≥65 years). The two main self-reported outcome measures were (1) frequency of falls in the 3 months prior to the survey interview date and (2) the number of injuries resulting from these falls. Prevalence ratios (PRs) and 95% CIs were calculated using Poisson regression models with robust SEs.
  
  
  RESULTS
  Of 340,680 survey participants aged ≥45 years, 70.7% reported engaging in LTPA, and 17% reported one or more falls. Among those reporting a fall within 3 months, 25.6% experienced one injurious fall (fall resulting in an injury) and 8.4% reported two or more injurious falls. Controlling for sociodemographic and health characteristics, among adults aged 45-54 years, those who engaged in LTPA were significantly less likely to report one fall (PR=0.90, 95% CI=0.81, 0.99); two or more falls (PR=0.84, 95% CI=0.77, 0.93); one injurious fall (PR=0.88, 95% CI=0.78, 0.99); and two or more injurious falls (PR=0.69, 95% CI=0.58, 0.83) than those who did not exercise. A similar protective effect of LTPA on reporting falls and injuries was noted for adults aged 55-64 and ≥65 years.
  
  
  CONCLUSIONS
  Similar to older adults, middle-aged adults who engage in LTPA report fewer falls and fall-related injuries. Upon further confirmation of the relationship between LTPA and falls among middle-aged adults, fall prevention interventions could be developed for this population.
authors.affiliation: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Caban-Martinez
authors.affiliation: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Theodore K
authors.initials: TK
authors.lastname: Courtney
authors.affiliation: Center for Physical Ergonomics, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.
authors.forename: Wen-Ruey
authors.initials: WR
authors.lastname: Chang
authors.affiliation: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: David A
authors.initials: DA
authors.lastname: Lombardi
authors.affiliation: Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.
authors.forename: Yueng-Hsiang
authors.initials: YH
authors.lastname: Huang
authors.affiliation: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.
authors.forename: Melanye J
authors.initials: MJ
authors.lastname: Brennan
authors.affiliation: Department of Environmental and Occupational Health, The George Washington University, Washington, District of Columbia;
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Perry
authors.affiliation: Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.affiliation: Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.affiliation: Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: santosh.verma@libertymutual.com.
authors.forename: Santosh K
authors.initials: SK
authors.lastname: Verma
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*