Aging Clinical and Experimental Research

, Volume 20, Issue 3, pp 234–241 | Cite as

Physical function, physical activity and recent falls. Results from the “Invecchiamento e Longevità nel Sirente (ilSIRENTE)” Study

  • Irene Mangani
  • Matteo CesariEmail author
  • Andrea Russo
  • Graziano Onder
  • Cinzia Maraldi
  • Valentina Zamboni
  • Niccolò Marchionni
  • Roberto Bernabei
  • Marco Pahor
  • Francesco Landi
Original Article


Background and aims: A fall is a common and traumatic event in the life of older persons. This study aims: 1) to explore the relationship between recent falls and measures of physical function in elders, and 2) to examine the role played by habitual physical activity in the relationship between recent falls and physical function. Methods: We used baseline data from 361 community-dwelling persons aged ≥80 years (mean age 85.9 yrs) enrolled in the “Invecchiamento e Longevità nel Sirente (ilSIRENTE)” study. Physical performance was assessed using the Short Physical Performance Battery (SPPB) and usual gait speed. Muscle strength was measured by hand grip strength. Functional status was assessed by the Basic (ADL) and Instrumental Activities of Daily Living (IADL) scales. Self-reported recent falls over the previous three months were recorded. Analyses of covariance were performed to evaluate the relationship between recent fall events and physical function measures. Results: Fifty participants (13.9%) reported at least one recent fall. Physically active participants had fewer falls and significantly higher physical function compared with sedentary subjects, regardless of recent falls. Significant interactions for physical activity were found in the relationships of usual gait speed and SPPB with recent fall history (p for interaction terms <0.01). A difference in usual gait speed and SPPB according to history of recent falls was found only in physically active subjects. Conclusions: Physical performance measures are negatively associated with recent falls in physically active, but not sedentary, participants. Physical activity is associated with better physical function, independently of recent fall history.


Hand grip strength physical activity physical performance recent falls usual gait speed 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Tinetti ME, Williams CS. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol A Biol Sci Med Sci 1998; 53: M112–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Josephson KR, Fabacher DA, Rubenstein LZ. Home safety and fall prevention. Clin Geriatr Med 1991; 7: 707–31.PubMedGoogle Scholar
  3. 3.
    Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-lwelling elderly. J Manag Care Pharm 2005; 11: 307–16.PubMedGoogle Scholar
  4. 4.
    Applegate WB, Blass JP, Williams TF. Instruments for the functional assessment of older patients. N Engl J Med 1990; 322: 1207–14.PubMedCrossRefGoogle Scholar
  5. 5.
    Scott WK, Macera CA, Cornman CB, Sharpe PA. Functional health status as a predictor of mortality in men and women over 65. J Clin Epidemiol 1997; 50: 291–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995; 332: 556–61.PubMedCrossRefGoogle Scholar
  7. 7.
    Rantanen T, Guralnik JM, Foley D, et al. Midlife hand grip strength as a predictor of old age disability. JAMA 1999; 281: 558–60.PubMedCrossRefGoogle Scholar
  8. 8.
    Inouye SK, Peduzzi PN, Robinson JT, et al. Importance of functional measures in predicting mortality among older hospitalized patients. JAMA 1998; 279: 1187–93.PubMedCrossRefGoogle Scholar
  9. 9.
    Al Snih S, Markides KS, Ray L, Ostir GV, Goodwin JS. Handgrip strength and mortality in older Mexican Americans. J Am Geriatr Soc 2002; 50: 1250–6.PubMedCrossRefGoogle Scholar
  10. 10.
    de Rekeneire N, Visser M, Peila R, et al. Is a fall just a fall: correlates of falling in healthy older persons. The Health, Aging and Body Composition Study. J Am Geriatr Soc 2003; 51: 841–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Nevitt MC, Cummings SR, Kidd S, Black D. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 1989; 261: 2663–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Gerdhem P, Ringsberg KA, Akesson K, Obrant KJ. Clinical history and biologic age predicted falls better than objective functional tests. J Clin Epidemiol 2005; 58: 226–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Bean JF, Vora A, Frontera WR. Benefits of exercise for community-dwelling older adults. Arch Phys Med Rehabil 2004; 85 (Suppl 3): 31–42.CrossRefGoogle Scholar
  14. 14.
    Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56: M146–56.PubMedCrossRefGoogle Scholar
  15. 15.
    Landi F, Russo A, Cesari M, et al. The ilSIRENTE study: a prospective cohort study on persons aged 80 years and older living in a mountain community of Central Italy. Aging Clin Exp Res 2005; 17: 486–93.PubMedGoogle Scholar
  16. 16.
    Morris JN, Fries BE, Bernabei R, et al. RAI — Home Care assessment manual. Washington, DC: InterRAI Coporation, 1996.Google Scholar
  17. 17.
    Hawes C, Morris JN, Phillips CD, et al. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist 1995; 35: 172–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Landi F, Tua E, Onder G, et al. Minimum data set for home care: a valid instrument to assess frail older people living in the community. Med Care 2000; 38: 1184–90.PubMedCrossRefGoogle Scholar
  19. 19.
    Ferrucci L, Bandinelli S, Benvenuti E, et al. Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study. J Am Geriatr Soc 2000; 48: 1618–25.PubMedGoogle Scholar
  20. 20.
    Landi F, Onder G, Cesari M, et al. Psychotropic medications and risk for falls among community-dwelling frail older people: an observational study. J Gerontol A Biol Sci Med Sci 2005; 60: 622–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery. J Gerontol A Biol Sci Med Sci 2000; 55A: M221–31.CrossRefGoogle Scholar
  22. 22.
    Pahor M, Chrischilles EA, Guralnik JM, et al. Drug data coding and analysis in epidemiologic studies. Eur J Clin Epidemiol 1994; 10: 405–11.CrossRefGoogle Scholar
  23. 23.
    Bugeja G, Kumar A, Banerjee AK. Exclusion of elderly people from clinical research: a descriptive study of published reports. BMJ 1997; 315: 1059.PubMedCrossRefGoogle Scholar
  24. 24.
    World population in 2300. Proceedings of the United Nations Expert Meeting on World Population Projections. New York. NY: United Nations, 2003.Google Scholar
  25. 25.
    Nikolaus T, Bach M, Oster P, Schlierf G. Prospective value of self-report and performance-based tests of functional status for 18-month outcomes in elderly patients. Aging Clin Exp Res 1996; 8: 271–6.Google Scholar
  26. 26.
    Rozzini R, Frisoni GB, Bianchetti A, Zanetti O, Trabucchi M. Physical Performance Test and Activities of Daily Living scales in the assessment of health status in elderly people. J Am Geriatr Soc 1993; 41: 1109–13.PubMedGoogle Scholar
  27. 27.
    Cesari M, Kritchevsky SB, Penninx BWJH, et al. Prognostic value of usual gait speed in well-functioning elders — Results from the Health. Aging and Body Composition (Health ABC) study. J Am Geriatr Soc 2005; 53: 1675–80.PubMedCrossRefGoogle Scholar
  28. 28.
    Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001; 49: 664–72.CrossRefGoogle Scholar
  29. 29.
    Smith EL, Gilligan C. Physical activity effects on bone metabolism. Calcif Tissue Int 1991; 49: S50–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Ferrucci L, Izmirlian G, Leveille S, et al. Smoking, physical activity, and active life expectancy. Am J Epidemiol 1999; 149: 645–53.PubMedCrossRefGoogle Scholar
  31. 31.
    Haight T, Tager I, Sternfeld B, Satariano W, van der Laan M. Effects of body composition and leisure-time physical activity on transitions in physical functioning in the elderly. Am J Epidemiol 2005; 162: 607–17.PubMedCrossRefGoogle Scholar
  32. 32.
    Sternfeld B, Ngo L, Satariano WA, Tager IB. Associations of body composition with physical performance and self-reported functional limitation in elderly men and women. Am J Epidemiol 2002; 156: 110–21.PubMedCrossRefGoogle Scholar
  33. 33.
    Colbert LH, Visser M, Simonsick EM, et al. Physical activity, exercise, and inflammatory markers in older adults: findings from the Health. Aging and Body Composition study. J Am Geriatr Soc 2004; 52: 1098–104.PubMedCrossRefGoogle Scholar
  34. 34.
    Penninx BWJH, Kritchevsky SB, Newman AB, et al. Inflammatory markers and incident mobility limitation in the elderly. J Am Geriatr Soc 2004; 52: 1105–13.PubMedCrossRefGoogle Scholar
  35. 35.
    Penninx BW, Rejeski WJ, Pandya J, et al. Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. J Gerontol B Psychol Sci Soc Sci 2002; 57: P124–32.PubMedCrossRefGoogle Scholar
  36. 36.
    Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701–7.PubMedCrossRefGoogle Scholar
  37. 37.
    O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 1993; 137: 342–54.PubMedGoogle Scholar
  38. 38.
    Cummings SR, Nevitt MC, Kidd S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 1988; 36: 613–6.PubMedGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2008

Authors and Affiliations

  • Irene Mangani
    • 1
    • 2
  • Matteo Cesari
    • 2
    • 3
    Email author
  • Andrea Russo
    • 3
  • Graziano Onder
    • 3
  • Cinzia Maraldi
    • 2
  • Valentina Zamboni
    • 3
  • Niccolò Marchionni
    • 1
  • Roberto Bernabei
    • 3
  • Marco Pahor
    • 2
  • Francesco Landi
    • 3
  1. 1.Department of Critical Care Medicine and Surgery,Unit of Geriatric MedicineUniversity of FlorenceFlorenceItaly
  2. 2.Department of Aging and Geriatric ResearchUniversity of Florida — Institute on AgingGainesvilleUSA
  3. 3.Department of Gerontology, Geriatrics and PhysiatricsCatholic University of the Sacred HeartRomeItaly

Personalised recommendations