Keywords
Fall
Physical activity
Sedentary
How to Cite
Abstract
Introduction: Falls are a major public health concern among older adults, contributing to significant mortality, morbidity, and disability. Physical activity has been shown to improve balance, strength, and overall physical function, which can help reduce fall risk.
Objectives: To explore the association between physical activity levels and fall risk among community-dwelling elders.
Methodology: A cross-sectional study was conducted in Dhulikhel municipality from 10 May, 2024, to 12 March, 2025. A total of 128 elderly individuals (aged ≥65 years) were selected using cluster random sampling. Data were collected through face-to-face interviews using a structured questionnaire, and the Global Physical Activity Questionnaire was used to assess physical activity. Risk of fall was assessed using the Timed Up and Go test. Descriptive statistics were used to describe socio-demographic characteristics, and a chi-square test was used to examine the association between physical activity levels and fall risk.
Results: Among 128 participants, 45.3% were at risk of falls. The prevalence of falls increased with age, particularly in individuals aged ≥75 years (p-value <0.001). A significant association was found between physical activity levels and fall risk,( p-value <0.001). Participants with low physical activity were more likely to be at risk of falling compared to those with moderate to high physical activity.
Conclusion: The study highlights the protective role of physical activity in reducing fall risk among the elderly. Tailored interventions promoting regular physical activity may help reduce fall-related injuries and improve overall health in elderly populations.
References
Gilbert SF. Developmental biology 6th ed. Sunderland (MA): Sinauer Associates; 2000. Aging: the biology of senescence. [PubMed |Full Text]
Orimo H, Ito H, Suzuki T, Araki A, Hosoi T, Sawabe M. Reviewing the definition of “elderly”. Geriatrics & gerontology international. 2006 Sep; 6(3):149-58. [Full Text | DOI]
World Health Organization: WHO. Ageing and health 2024. [Full Text ]
The Global Economy. Nepal population aged 65 years and above. [Full Text ]
Appeadu MK, Bordoni B. Falls and fall prevention in older adults. Stat Pearls -NCBI Bookshelf. 2023. [PubMed | Full Text]
Ageing and Health (AAH). WHO global report on falls prevention in older age. 2008. [Full Text]
Gupta S, Gupta SK, Devkota S, Ranjit A, Swaroop M, Kushner AL, Nwomeh BC, Victorino GP. Fall Injuries in Nepal: A Countrywide Population-based Survey. Ann Glob Health. 2015 Jul-Aug;81(4):487-94. [PubMed | Full Text]
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson L, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD007146. [ Full Text |DOI]
Sherrington C, Fairhall N, Kwok W, Wallbank G, Tiedemann A, Michaleff ZA, A.C.M.Ng Christopher and Bauman A. Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behavior. International Journal of Behavioral Nutrition and Physical Activity. 2020 Nov 26;17(1). [PubMed | Full Text| DOI]
World Health Organization. Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: WHO; 2018. [Full Text]
Bauman A, Merom D, Bull FC, Buchner DM, Fiatarone Singh MA. Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological Evidence, Prevalence, and Interventions to Promote "Active Aging". Gerontologist. 2016 Apr;56 Suppl2:S268-80. [PubMed | Full Text | DOI]
Soares WJS, Lopes AD, Nogueira E, Candido V, De Moraes SA, Perracini MR. Physical Activity Level and Risk of Falling in Community-Dwelling Older Adults: Systematic Review and Meta-Analysis. Journal of Aging and Physical Activity. 2018 Mar 15;27(1):34–43. [PubMed | Full Text | DOI]
Lee J. The association between physical activity and risk of falling in older adults: A systematic review and meta-analysis of prospective cohort studies. Geriatric Nursing 2020 Jun 2;41(6):747–53. [PubMed | Full Text | DOI]
Thibaud M, Bloch F, Tournoux-Facon C, Brèque C, Rigaud AS, Dugué B, Kemoun G. Impact of physical activity and sedentary behaviour on fall risks in older people: a systematic review and meta-analysis of observational studies. Arch Gerontol Geriatr. 2012;54(1):e79–e86. [Full Text | DOI]
Tolley APL, Ramsey KA, Rojer AGM, Reijnierse EM, Maier AB. Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review. J Clin Epidemiol. 2021 Sep; 137:218-230. [PubMed | Full Text| DOI]
Liang C, Shi L, Li B, He Z. The Mediating Role of Sarcopenia in the Association between Physical Activity and Falls among Chinese Older Adults: A Cross-Sectional Study. Healthcare [Internet]. 2023 Dec 12;11(24):3146. [PubMed | Full Text| DOI]
World Health Organization. Global Physical Activity Questionnaire (GPAQ): Analysis Guide. Geneva: WHO; 2012. [Full Text]
Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr 2014 Jan 20;14(1):14. [PubMed | Full Text| DOI]
Zhao J, Liang G, Huang H, Zeng L, Yang W, Pan J, Liu. J. Identification of risk factors for falls in postmenopausal women: a systematic review and meta-analysis. Osteoporosis International. 2020 Jun 26;31(10):1895–904. [PubMed | Full Text | DOI]
Moreland B, Kakara R, Henry A. Trends in nonfatal falls and fall-related injuries among adults aged ≥65 years - United States, 2012-2018. MMWR Morb Mortal Wkly Rep. 2020 Jul 10;69(27):875-81. [PubMed | Full Text| DOI]
Kakara R, Bergen G, Burns E. Understanding the association of older adult fall risk factors by age and sex through factor analysis. Journal of Applied Gerontology 2023 Feb 1;42(7):1662–71. [PubMed | Full Text| DOI]
Balogun S, Winzenberg T, Wills K, Scott D, Jones G, Callisaya M, et al. Longitudinal associations between serum 25-hydroxyvitamin D, physical activity, knee pain and dysfunction and physiological falls risk in community-dwelling older adults. Experimental Gerontology. 2018 Feb;104:72–7. [PubMed | Full Text| DOI]
Warzecha M, Amarowicz J, Berwecka M, Czerwiński E, Kumorek A. Relation between risk of falls, sarcopenia and parameters assessing quality of skeletal muscles in a group of postmenopausal women. Menopause Rev. 2020;19(3):123–9. [PubMed | Full Text| DOI]
Tak E, Kuiper R, Chorus A, Hopman-Rock M. Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: a meta-analysis. Ageing Res Rev. 2012 Oct 10;12(1):329-38. [PubMed | Full Text| DOI]
Lu Z, Lam FMH, Leung JCS, Kwok TCY. The U-shaped relationship between levels of bouted activity and fall incidence in community-dwelling older adults: a prospective cohort study. J Gerontol A Biol Sci Med Sci. 2020 Oct;75(10):e145-e151. [PubMed | Full Text | DOI]
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JC, Lord SR. Exercise to prevent falls in older adults: an updated systematic review and metaanalysis. Br J Sports Med. 2016 Oct 4;51(24):1750. [PubMed | Full Text| DOI]