Skip to main content
SpringerLink
Log in

Association between accelerometer-measured physical activity and falls among community-dwelling older people living in cold, snowy areas

  • Research Paper
  • Published:
European Geriatric Medicine Aims and scope Submit manuscript

Key summary points

AbstractSection Aim

To investigate the association between falls and accelerometer measured physical activity among older people living in cold, snowy regions in Japan.

AbstractSection Findings

A higher moderate-to-vigorous intensity physical activity levels and walking steps were associated with falls on a frozen road.

AbstractSection Message

The risk of falls, especially on frozen roads, increased among active older people living in cold, snowy regions, and environmental factors should be considered when determining prevention strategies.

Abstract

Purpose

The aim of the present study was to investigate the association between falls, including falls on frozen roads, and physical activity among older people living in cold, snowy regions in Japan.

Methods

Participants were subjects of the Japan Gerontological Evaluation Study 2016 who had agreed to the Hokkaido additional visit survey in winter 2017/18 and lived in cold, snowy regions in Japan. The analysis included 461 participants (mean age 74.7 years; standard deviation 2.8 years; 46.5% male). Sociodemographic characteristics, physical activity (min/day of moderate-to-vigorous intensity physical activity [MVPA] and light intensity physical activity, and walking steps/day) measured by accelerometer, cognitive function, depression, visual impairment, and history of stroke were surveyed. Poisson regression analyses were performed to clarify the association between prevalence of falls and physical activity.

Results

Of those who reported a fall with location, 86 (69.9%) fell on frozen roads, 24 (19.5%) fell on unfrozen roads and 13 (10.6%) fell indoors. There were significant positive associations between MVPA (adjusted prevalence ratio [aPR] Tertile [T] 3 vs T1, 1.73; 95% confidence interval [CI], 1.04–2.87) and all falls. When limited to falls on frozen roads, higher MVPA levels and walking steps were associated with falls on frozen roads (MVPA, aPR T3 vs T1, 2.16; 95% CI, 1.19–3.94; walking steps, aPR T3 vs T1, 2.49; 95%CI 1.33–4.68).

Conclusion

The risk of falls, especially on frozen roads, increased among active older people living in cold, snowy regions, and environmental factors should be considered when determining prevention strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Code availability

Not applicable.

References

  1. Ministry of Health, Labor and Welfare. Overview of 2016 Basic Survey on People's Life. 2017. https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa16/dl/16.pdf.

  2. Connell BR, Wolf SL. Environmental and behavioral circumstances associated with falls at home among healthy elderly individuals. Atlanta FICSIT Group. Archives of physical medicine and rehabilitation. 1997;78(2):179–86

  3. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology (Cambridge, Mass) 21(5):658–668

    Article  Google Scholar 

  4. Bath PA, Morgan K (1999) Differential risk factor profiles for indoor and outdoor falls in older people living at home in Nottingham. UK Eur J Epidemiol 15(1):65–73

    Article  CAS  Google Scholar 

  5. Bergland A, Pettersen AM, Laake K (1998) Falls reported among elderly Norwegians living at home. Physiotherap Res Int 3(3):164–174

    Article  CAS  Google Scholar 

  6. Kelsey JL, Berry SD, Procter-Gray E, Quach L, Nguyen US, Li W et al (2010) Indoor and outdoor falls in older adults are different: the maintenance of balance, independent living, intellect, and Zest in the Elderly of Boston Study. J Am Geriatr Soc 58(11):2135–2141

    Article  Google Scholar 

  7. Li W, Keegan TH, Sternfeld B, Sidney S, Quesenberry CP Jr, Kelsey JL (2006) Outdoor falls among middle-aged and older adults: a neglected public health problem. Am J Public Health 96(7):1192–1200

    Article  Google Scholar 

  8. Manty M, Heinonen A, Viljanen A, Pajala S, Koskenvuo M, Kaprio J et al (2009) Outdoor and indoor falls as predictors of mobility limitation in older women. Age Ageing 38(6):757–761

    Article  Google Scholar 

  9. O'Loughlin JL, Boivin JF, Robitaille Y, Suissa S (1994) Falls among the elderly: distinguishing indoor and outdoor risk factors in Canada. J Epidemiol Community Health 48(5):488–489

    Article  CAS  Google Scholar 

  10. Bea JW, Thomson CA, Wallace RB, Wu C, Seguin RA, Going SB et al (2017) Changes in physical activity, sedentary time, and risk of falling: the Women's Health Initiative Observational Study. Prev Med 95:103–109

    Article  Google Scholar 

  11. Chan BK, Marshall LM, Winters KM, Faulkner KA, Schwartz AV, Orwoll ES (2007) Incident fall risk and physical activity and physical performance among older men: the Osteoporotic Fractures in Men Study. Am J Epidemiol 165(6):696–703

    Article  Google Scholar 

  12. Heesch KC, Byles JE, Brown WJ (2008) Prospective association between physical activity and falls in community-dwelling older women. J Epidemiol Community Health 62(5):421–426

    Article  CAS  Google Scholar 

  13. Mertz KJ, Lee DC, Sui X, Powell KE, Blair SN (2010) Falls among adults: the association of cardiorespiratory fitness and physical activity with walking-related falls. Am J Prev Med 39(1):15–24

    Article  Google Scholar 

  14. Peeters GM, van Schoor NM, Pluijm SM, Deeg DJ, Lips P (2010) Is there a U-shaped association between physical activity and falling in older persons? Osteoporos Int 21(7):1189–1195

    Article  CAS  Google Scholar 

  15. Buchner DM, Rillamas-Sun E, Di C, LaMonte MJ, Marshall SW, Hunt J et al (2017) Accelerometer-measured moderate to vigorous physical activity and incidence rates of falls in older women. J Am Geriatr Soc 65(11):2480–2487

    Article  Google Scholar 

  16. Jefferis BJ, Merom D, Sartini C, Wannamethee SG, Ash S, Lennon LT et al (2015) Physical activity and falls in older men: the critical role of mobility limitations. Med Sci Sports Exerc 47(10):2119–2128

    Article  Google Scholar 

  17. Klenk J, Kerse N, Rapp K, Nikolaus T, Becker C, Rothenbacher D et al (2015) Physical activity and different concepts of fall risk estimation in older people-results of the ActiFE-Ulm study. PLoS ONE 10(6):e0129098

    Article  Google Scholar 

  18. Al-Azzani W, Adam Maliq Mak D, Hodgson P, Williams R. Epidemic of fractures during a period of snow and ice: has anything changed 33 years on? BMJ Open. 2016;6(9):e010582

  19. Douglas S, Bunyan A, Chiu KH, Twaddle B, Maffulli N (2000) Seasonal variation of hip fracture at three latitudes. Injury 31(1):11–19

    Article  CAS  Google Scholar 

  20. Kihara Y, Yamaguchi R, Makino K, Shimizu K, Ito K, Furuna T (2019) Relationship between the occurrence of falls by season and physical functions of community-dwelling old-old people living in cold, snowy areas. Geriatr Gerontol Int 19(2):124–129

    Article  Google Scholar 

  21. Kondo K, Rosenberg M (eds) (2018) Advancing universal health coverage through knowledgetranslation for for healthy ageing: lessons learnt from the Japan Gerontological Evaluation Study. World Health Organization, Geneva

    Google Scholar 

  22. Park J, Ishikawa-Takata K, Tanaka S, Bessyo K, Tanaka S, Kimura T (2017) Accuracy of estimating step counts and intensity using accelerometers in older people with or without assistive devices. J Aging Phys Activity 25(1):41–50

    Article  Google Scholar 

  23. Matthews CE, Hagstromer M, Pober DM, Bowles HR (2012) Best practices for using physical activity monitors in population-based research. Med Sci Sports Exerc 44(1 Suppl 1):S68–76

    Article  Google Scholar 

  24. Trost SG, McIver KL, Pate RR (2005) Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc 37(11 Suppl):S531–S543

    Article  Google Scholar 

  25. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE et al (2017) Sedentary behavior research network (SBRN) - terminology consensus project process and outcome. Int J Behav Nutr Phys Activity 14(1):75

    Article  Google Scholar 

  26. Fujiwara Y, Suzuki H, Yasunaga M, Sugiyama M, Ijuin M, Sakuma N et al (2010) Brief screening tool for mild cognitive impairment in older Japanese: validation of the Japanese version of the Montreal Cognitive Assessment. Geriatr Gerontol Int 10(3):225–232

    Article  Google Scholar 

  27. Burke WJ, Roccaforte WH, Wengel SP (1991) The short form of the Geriatric Depression Scale: a comparison with the 30-item form. J Geriatr Psychiatry Neurol 4(3):173–178

    CAS  PubMed  Google Scholar 

  28. Friedman B, Heisel MJ, Delavan RL (2005) Psychometric properties of the 15-item geriatric depression scale in functionally impaired, cognitively intact, community-dwelling elderly primary care patients. J Am Geriatr Soc 53(9):1570–1576

    Article  Google Scholar 

  29. McNutt LA, Wu C, Xue X, Hafner JP (2003) Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 157(10):940–943

    Article  Google Scholar 

  30. Amagasa S, Kikuchi H, Fukushima N, Odagiri Y, Takamiya T, Oka K et al (2018) Types of social participation and patterns of objectively determined sedentary behavior and physical activity in community-dwelling older adults. Res Exerc Epidemiol 20(1):5–15

    Google Scholar 

  31. Kitayuguchi J, Kamada M, Inoue S, Kamioka H, Abe T, Okada S et al (2016) Association of physical activity and sedentary behavior with falls in Japanese community-dwelling older adults: a 1-year prospective cohort study. Res Exerc Epidemiol 18(1):1–14

    Google Scholar 

  32. Inoue S, Ohya Y, Odagiri Y, Takamiya T, Kamada M, Okada S et al (2010) Characteristics of accelerometry respondents to a mail-based surveillance study. J Epidemiol 20(6):446–452

    Article  Google Scholar 

  33. Haga H, Yasumura S, Niino N, Ueno H, Oshima M, Higuchi Y. [An examination of two reporting methods of falls among the elderly living in the community]. [Nihon koshu eisei zasshi]. Jpn Public Health. 1996;43(11):983–8

  34. Fujimoto K, Kondo H, Okada K, Wang DG, Asai H, Shinkai S et al. [A comparison between three methods to investigate falls among the elderly living in the community]. [Nihon koshu eisei zasshi] Japanese journal of public health. 2000;47(5):430–9

Download references

Acknowledgments

The authors express their sincere appreciation to the study participants. We wish to express our sincere thanks to Dr. Zentaro Yamagata, Department of Health Sciences, School of Medicine, University of Yamanashi, for statistical advice. We thank Helen Jeays, BDSc AE, from Edanz Group (https://en-author-services.edanzgroup.com/) for editing a draft of this manuscript.

Funding

This work was supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology [JP17K19778, JP17H04129, JP18H05389 and JP20H00557].

Author information

Authors and Affiliations

  1. Department of Health Sciences, School of Medicine, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi, 409-3898, Japan

    Reiji Kojima & Hiroshi Yokomichi

  2. Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan

    Reiji Kojima, Aya Tanaka, Takashi Kimura & Akiko Tamakoshi

  3. Graduate School of Human Life Science, Research Unit of Advanced Interdisciplinary Care Science, Osaka City University, Osaka, Japan

    Shigekazu Ukawa

  4. Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan

    Shiho Amagasa & Shigeru Inoue

  5. Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan

    Katsunori Kondo

  6. Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan

    Katsunori Kondo

Authors
  1. Reiji Kojima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shigekazu Ukawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroshi Yokomichi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aya Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shiho Amagasa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shigeru Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Katsunori Kondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Akiko Tamakoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RK contributed to the study concept and design, analysis and interpretation of the data, and preparation of manuscript. HY, SA and SI contributed to the analysis and interpretation of the data, and critical review. KK, SU, AT, TK and AT contributed to study concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and critical review.

Corresponding author

Correspondence to Reiji Kojima.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was approved by the Ethics Review Committee of the Hokkaido University Graduate School of Medicine and Chiba University. This study was performed in line with the principles of the Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all participants.

Consent for publication

Not applicable.

Availability of data and material (data transparency)

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 170 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kojima, R., Ukawa, S., Yokomichi, H. et al. Association between accelerometer-measured physical activity and falls among community-dwelling older people living in cold, snowy areas. Eur Geriatr Med 12, 91–98 (2021). https://doi.org/10.1007/s41999-020-00398-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41999-020-00398-9

Keywords

Search

Navigation