title: Race and fall risk: data from the National Health and Aging Trends Study (NHATS).
abstract: OBJECTIVE
  the objective of this study was to explore whether race-based difference in fall risk may be mediated by environmental and physical performance risk factors.
  
  
  METHODS
  using data from a nationally representative longitudinal survey of 7,609 community-dwelling participants in the National Health and Aging Trends Study (NHATS), we evaluated whether racial differences in fall risk may be explained by physical performance level (measured by the Short Physical Performance Battery), mobility disability, physical activity level and likelihood of living alone. Multivariate Poisson regression and mediation models were used in analyses.
  
  
  RESULTS
  in whites and blacks, the annual incidence of 'any fall' was 33.8 and 27.1%, respectively, and the annual incidence of 'recurrent falls' was 15.5 and 12.3%, respectively. Compared with whites, blacks had relative risks of 0.7 (95% confidence interval 0.6-0.8) and 0.6 (0.5-0.8) for sustaining any fall and recurrent falls, respectively, in adjusted analyses. Blacks had poorer performance on the SPPB (P < 0.001), higher levels of mobility disability (P < 0.001), similar levels of physical activity (P = 0.19) and were equally likely to live alone relative to whites (P = 0.77). Mediation analysis revealed that these risk factors collectively acted as suppressors and none of these factors accounted for the racial differences in fall risk observed.
  
  
  CONCLUSIONS
  relative to whites, blacks were at 30 and 40% decreased risk of sustaining any fall and recurrent falls, respectively. This difference in risk remains unexplained.
authors.affiliation: Department of Otolaryngolgoy-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Daniel Q
authors.initials: DQ
authors.lastname: Sun
authors.affiliation: The Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.affiliation: The Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA Division of Biostatistics and Bioinformatics, Department of Oncology, Sidney Kimmel Comprehensive Care Center, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Varadhan
authors.affiliation: Department of Otolaryngolgoy-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA The Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Agrawal
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology*; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status / Q000208:ethnology; D006278:Medicare; D051346:Mobility Limitation; D009043:Motor Activity; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: Short Physical Performance Battery; fall; older people; physical activity; race