This study aimed to explore the association between HPA domains and fall incidence among older adults, and to examine how these associations vary by residence, gender, age, and basic-mobility, to inform targeted fall prevention strategies.
A population-based cross-sectional study was conducted with 175 participants (57% men), aged 65-92 years, residing in urban and rural areas of Northern Iceland. The Physical Activity Scale for the Elderly (PASE) was used to measure HPA across three domains using its sub-scales: PASE-leisure, PASE-home, and PASE-work. Participants reported their fall incidence over the past 12 months. The main background variables were residence, gender, age, and basic-mobility. Statistical analyses included independent t-tests, Mann-Whitney U tests, and univariable and multivariable logistic regression. Statistical significance was set at p 0.05.
Participants who experienced at least one fall (≥1 fall) or recurrent falls (≥2 falls) had lower PASE-home scores than other participants (p = 0.029 and 0.043, respectively), but those with recurrent falls had higher PASE-work scores (p = 0.037). Adjusting for other PASE variables, each additional point on the PASE-home scale decreased the odds of a fall and recurrent falls by 1%. Adjusting for PASE and other background variables, residence, gender, and age group remained strong associates of fall history. Rural residents had eight times greater odds of falling than urban residents, with the odds of recurrent falls increasing to 23 times greater. Men had 50% greater odds of falling and eight times greater odds of recurrent falls compared to women. Participants aged 75+ had reduced odds of both a fall and recurrent falls compared to those aged 65-74, with odds ratios of 0.43 and 0.30, respectively.
The findings indicate that HPA related to household tasks is associated with a lower likelihood of falls, while physically demanding work activities are linked to a higher likelihood of recurrent falls. Future research should further explore these associations to refine and validate fall prevention approaches. Additionally, factors such as residence, gender and age, are significant in understanding fall risk among older adults.
The results underscore the need for targeted interventions in physiotherapy practice that promote HPA in different domains, associated with reduced fall risk. This may include developing tailored interventions to increase household-related HPA while managing risks from physically demanding work-related activities. Given the higher fall risk observed among rural residents and men, policies should address these specific groups by improving access to fall prevention resources and support.
Physical activity
Aged
