Joint Association of Diabetes and Physical Activity With Falls Among Midlife and Older Adults: 2018 Behavioral Risk Factor Surveillance System

• Published in: American journal of health promotion Vol. 37; no. 5; pp. 669 - 674
• Main Authors: Oh, Minsuk, Ylitalo, Kelly R.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2023; American Journal of Health Promotion
• Subjects: Ambiguity; Associations; Causality; Diabetes; Exercise; Falls; Health care; Health promotion; Leisure; Middle age; Midlife; Mobile phones; Older people; Physical activity; Polls & surveys; Recall; Response rates; Risk behavior; Risk factors; Surveillance; Surveillance systems; falls; aging; diabetes; physical activity; disease management
• ISSN: 0890-1171; 2168-6602; 2168-6602
• DOI: 10.1177/08901171221141077

Purpose We examined joint associations of diabetes and physical activity (PA) with falls. Design Complex survey (cross-sectional) design using the 2018 Behavioral Risk Factor Surveillance System (Response rate was 53% (landline phones) and 46% (cellular phones)). Setting National survey in the U.S. Subjects Adults ≥45 years who self-reported diabetes status, PA, and falls (n = 295,282; 98.5% of eligible samples; N = 130,103,093) were classified into 4 groups: no diabetes–PA, no diabetes–no PA, diabetes–PA, diabetes–no PA. Measures Self-reported PA, diabetes, falls, and major health characteristics. Analysis Poisson regression models were used to estimate the association of groups with any (≥1 fall) falls. Results Compared to no diabetes–active groups, no diabetes–inactive (Relative Risk (RR) = 1.22; 95% CI: 1.18, 1.26), diabetes–active (RR = 1.25; 95% CI: 1.20, 1.30), and diabetes–inactive (RR = 1.46; 95% CI: 1.41, 1.51) groups were more likely to report falls, independent of tested covariates. Conclusions Leisure-time PA may mitigate the likelihood of falls in adults with and without diabetes. Our findings could be useful for healthcare providers or clinicians to promote the importance of PA in midlife and older adults who are at risk of falls and/or diabetes. More detailed longitudinal information on objectively-estimated PA and a more frequent fall calendar are warranted to prevent recall bias and temporal ambiguity (causality between PA and falls).