Falls, injuries, physical activity and ageing

Abstract

Falls and physical inactivity are major public health problems worldwide. The World Health Organization recommends older adults participate in at least 150 to 300 minutes of moderate-intensity physical activity per week to promote health and preserve physical function for healthy ageing. Structured exercise, a specific type of physical activity, reduces falls among older adults. However, about one in three adults worldwide is physically inactive, suggesting that behaviour change to maintain regular exercise and activity can be challenging.

Strategies incorporating behaviour change techniques may be beneficial to support ongoing participation in physical activity. However, trials have short durations and limited follow-up periods, resulting in insufficient evidence on the relationship between overall physical activity and fall-related injuries. There are important gaps in evidence about physical activity, physical function, falls, and fall-related injuries. Furthermore, research focusing on the association between physical activity and falls and physical activity and function in mid-life remains limited.

This thesis investigates the relationship between participant characteristics, intervention components, and adherence to fall prevention exercises. It also evaluates the association between physical activity participation and falls—both non-injurious and injurious—over both short and long terms, from mid-life to older age. It also examines the prospective bi-directional association between physical activity and physical function. This research utilises data from a large longitudinal study of middle-aged and older Australian women (“Australian Longitudinal Study on Women’s Health”). The associations were considered within a causal framework from directed acyclic graphs.