Differences in Falls between Older Adult Participants in Group Exercise and Those Who Exercise Alone: A Cross-Sectional Study Using Japan Gerontological Evaluation Study (JAGES) Data
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. History of Falls
2.3. Exercising Individually or Group Exercise Participation
2.4. Covariates
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Matsuda, R. Life-Style Choices and Falls. In Health Inequalities in Japan: An Empirical Study of Older People; Kondo, K., Ed.; Trans Pacific Press: Melbourne, VIC, Australia, 2010; pp. 37–50. [Google Scholar]
- Shimada, H.; Suzukawa, M.; Ishizaki, T.; Kobayashi, K.; Kim, H.; Suzuki, T. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people. BMC Geriatr. 2011, 11, 40. [Google Scholar] [CrossRef] [PubMed]
- Gates, S.; Fisher, J.D.; Cooke, M.W.; Carter, Y.H.; Lamb, S.E. Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: Systematic review and meta-analysis. BMJ (Clin. Res. Ed.) 2008, 336, 130–133. [Google Scholar] [CrossRef] [PubMed]
- Rubenstein, L.Z. Falls in older people: Epidemiology, risk factors and strategies for prevention. Age Ageing 2006, 35, ii37–ii41. [Google Scholar] [CrossRef] [PubMed]
- United Nations World Population Prospects: The 2012 Revision. Available online: https://esa.un.org/unpd/wpp/publications/Files/WPP2012_HIGHLIGHTS.pdf (accessed on 6 March 2018).
- Ministry of Health Labour and Welfare Summary Report of Comprehensive Survey of Living Conditions 2010. Available online: http://www.mhlw.go.jp/english/database/db-hss/dl/report_gaikyo_2010.pdf (accessed on 6 March 2018).
- Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J. Am. Geriatr. Soc. 2011, 59, 148–157. [Google Scholar]
- Gillespie, L.D.; Robertson, M.C.; Gillespie, W.J.; Sherrington, C.; Gates, S.; Clemson, L.M.; Lamb, S.E. Interventions for preventing falls in older people living in the community. Cochrane Database Syst. Rev. 2012, 9, Cd007146. [Google Scholar] [CrossRef] [PubMed]
- Sherrington, C.; Whitney, J.C.; Lord, S.R.; Herbert, R.D.; Cumming, R.G.; Close, J.C. Effective exercise for the prevention of falls: A systematic review and meta-analysis. J. Am. Geriatr. Soc. 2008, 56, 2234–2243. [Google Scholar] [CrossRef] [PubMed]
- El-Khoury, F.; Cassou, B.; Charles, M.A.; Dargent-Molina, P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: Systematic review and meta-analysis of randomised controlled trials. BMJ (Clin. Res. Ed.) 2013, 347, f6234. [Google Scholar] [CrossRef] [PubMed]
- Sherrington, C.; Tiedemann, A.; Fairhall, N.; Close, J.C.; Lord, S.R. Exercise to prevent falls in older adults: An updated meta-analysis and best practice recommendations. N. S. W. Public Health Bull. 2011, 22, 78–83. [Google Scholar] [CrossRef] [PubMed]
- Kanamori, S.; Takamiya, T.; Inoue, S.; Kai, Y.; Kawachi, I.; Kondo, K. Exercising alone versus with others and associations with subjective health status in older Japanese: The JAGES Cohort Study. Sci. Rep. 2016, 6, 39151. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kanamori, S.; Kai, Y.; Kondo, K.; Hirai, H.; Ichida, Y.; Suzuki, K.; Kawachi, I. Participation in sports organizations and the prevention of functional disability in older Japanese: The AGES Cohort Study. PLoS ONE 2012, 7, e51061. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Eime, R.M.; Harvey, J.T.; Brown, W.J.; Payne, W.R. Does sports club participation contribute to health-related quality of life? Med. Sci. Sports Exerc. 2010, 42, 1022–1028. [Google Scholar] [CrossRef] [PubMed]
- Hayashi, T.; Kondo, K.; Suzuki, K.; Yamada, M.; Matsumoto, D. Factors associated with falls in community-dwelling older people with focus on participation in sport organizations: The Japan gerontological evaluation study project. BioMed Res. Int. 2014, 2014, 537614. [Google Scholar] [CrossRef] [PubMed]
- Kondo, K. Progress in Aging Epidemiology in Japan: The JAGES Project. J. Epidemiol. 2016, 26, 331–336. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Yamamoto, T.; Kondo, K.; Misawa, J.; Hirai, H.; Nakade, M.; Aida, J.; Kondo, N.; Kawachi, I.; Hirata, Y. Dental status and incident falls among older Japanese: A prospective cohort study. BMJ Open 2012, 2, e001262. [Google Scholar] [CrossRef] [PubMed]
- Ochi, A.; Yokoyama, S.; Abe, T.; Yamada, K.; Tateuchi, H.; Ichihashi, N. Differences in muscle activation patterns during step recovery in elderly women with and without a history of falls. Aging Clin. Exp. Res. 2014, 26, 213–220. [Google Scholar] [CrossRef] [PubMed]
- Swanenburg, J.; de Bruin, E.D.; Uebelhart, D.; Mulder, T. Falls prediction in elderly people: A 1-year prospective study. Gait Posture 2010, 31, 317–321. [Google Scholar] [CrossRef] [PubMed]
- Cwikel, J.G.; Fried, A.V.; Biderman, A.; Galinsky, D. Validation of a fall-risk screening test, the Elderly Fall Screening Test (EFST), for community-dwelling elderly. Disabil. Rehabil. 1998, 20, 161–167. [Google Scholar] [CrossRef] [PubMed]
- Deandrea, S.; Lucenteforte, E.; Bravi, F.; Foschi, R.; La Vecchia, C.; Negri, E. Risk factors for falls in community-dwelling older people: A systematic review and meta-analysis. Epidemiology 2010, 21, 658–668. [Google Scholar] [CrossRef] [PubMed]
- Fabre, J.M.; Ellis, R.; Kosma, M.; Wood, R.H. Falls risk factors and a compendium of falls risk screening instruments. J. Geriatr. Phys. Ther. 2010, 33, 184–197. [Google Scholar] [PubMed]
- Mochida, Y.; Yamamoto, T.; Fuchida, S.; Aida, J.; Kondo, K. Does poor oral health status increase the risk of falls?: The JAGES Project Longitudinal Study. PLoS ONE 2018, 13, e0192251. [Google Scholar] [CrossRef] [PubMed]
- Toba, K.; Reiko, K.; Akiko, I.; Koichi, K. “Fall Risk Index” Helps Clinicians Identify High-risk Individuals. Jpn. Med. Assoc. J. 2009, 52, 237–242. [Google Scholar]
- Koyano, W.; Shibata, H.; Nakazato, K.; Haga, H.; Suyama, Y. Measurement of competence: Reliability and validity of the TMIG index of competence. Arch. Gerontol. Geriatr. 1991, 13, 103–116. [Google Scholar] [CrossRef]
- UK Data Service English Longitudinal Study of Ageing: Waves 0-7, 1998–2015. Available online: https://discover.ukdataservice.ac.uk/catalogue/?sn=5050#publications (accessed on 15 March 2018).
- Hamer, M.; de Oliveira, C.; Demakakos, P. Non-exercise physical activity and survival: English longitudinal study of ageing. Am. J. Prev. Med. 2014, 47, 452–460. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Burke, W.J.; Roccaforte, W.H.; Wengel, S.P. The short form of the Geriatric Depression Scale: A comparison with the 30-item form. J. Geriatr. Psychiatry Neurol. 1991, 4, 173–178. [Google Scholar] [CrossRef] [PubMed]
- Kanamori, S.; Takamiya, T.; Inoue, S. Group exercise for adults and elderly: Determinants of participation in group exercise and its associations with health outcome. J. Phys. Fit. Sports Med. 2015, 4, 315–320. [Google Scholar] [CrossRef] [Green Version]
- House, J.S.; Landis, K.R.; Umberson, D. Social relationships and health. Science 1988, 241, 540–545. [Google Scholar] [CrossRef] [PubMed]
- Street, G.; James, R.; Cutt, H. The relationship between organised physical recreation and mental health. Health Promot. J. Aust. 2007, 18, 236–269. [Google Scholar] [CrossRef]
- Noda, H.; Iso, H.; Toyoshima, H.; Date, C.; Yamamoto, A.; Kikuchi, S.; Koizumi, A.; Kondo, T.; Watanabe, Y.; Wada, Y.; et al. Walking and sports participation and mortality from coronary heart disease and stroke. J. Am. Coll. Cardiol. 2005, 46, 1761–1767. [Google Scholar] [CrossRef] [PubMed]
- Takeda, T.; Kondo, K.; Hirai, H. Psychosocial risk factors involved in progressive dementia-associated senility among the elderly residing at home. AGES Project—Three year cohort longitudinal study. Nihon Koshu Eisei Zasshi Jpn. J. Public Health 2010, 57, 1054–1065. [Google Scholar]
- Eime, R.M.; Young, J.A.; Harvey, J.T.; Charity, M.J.; Payne, W.R. A systematic review of the psychological and social benefits of participation in sport for adults: Informing development of a conceptual model of health through sport. Int. J. Behav. Nutr. Phys. Act. 2013, 10, 135. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Carron, A.V.; Hausenblas, H.A.; Mack, D. Social Influence and Exercise: A Meta-Analysis. J. Sport Exerc. Psychol. 1996, 18, 1–16. [Google Scholar] [CrossRef]
- Yokoyama, N.; Nishijima, T.; Maeda, S.; Kuno, S.; Ajisaka, R.; Matsuda, M. Effect of exercise program participation on personal factors of exercise adherence promotion in middle-aged and elderly subjects—Comparison of group and individual exercise program. Tairyoku Kagaku 2003, 52, 249–257. [Google Scholar] [CrossRef]
- Durbin, L.; Kharrazi, R.J.; Graber, R.; Mielenz, T.J. Social support and older adult falls. Inj. Epidemiol. 2016, 3, 4. [Google Scholar] [CrossRef] [PubMed]
- Ganz, D.A.; Higashi, T.; Rubenstein, L.Z. Monitoring falls in cohort studies of community-dwelling older people: Effect of the recall interval. J. Am. Geriatr. Soc. 2005, 53, 2190–2194. [Google Scholar] [CrossRef] [PubMed]
Participated in Group Exercise | |||
No Group Exercisers (Less Than Once a week) | Group Exercisers (Once a Week or More) | ||
Individual Exercise | No Individual Exercisers (Less than once a week) | No Exercise (NE) group | Group Exercise (GE) group |
Individual Exercisers (Once a week or more) | Individual Exercise (IE) group |
Total n (%) | No Exercise (NE) n (%) | Individual Exercise (IE) n (%) | Group Exercise (GE) n (%) | p | ||||||
---|---|---|---|---|---|---|---|---|---|---|
n | 19,257 | 7598 | 7849 | 3810 | ||||||
Age (years) | ||||||||||
65–69 | 5965 | (31.0) | 2403 | (31.6) | 2348 | (29.9) | 1214 | (31.9) | <0.001 | |
70–74 | 6090 | (31.6) | 2175 | (28.6) | 2590 | (33.0) | 1325 | (34.8) | ||
75–79 | 4064 | (21.1) | 1544 | (20.3) | 1703 | (21.7) | 817 | (21.4) | ||
80–84 | 2155 | (11.2) | 949 | (12.5) | 859 | (10.9) | 347 | (9.1) | ||
≥85 | 983 | (5.1) | 527 | (6.9) | 349 | (4.4) | 107 | (2.8) | ||
Sex | <0.001 | |||||||||
Male | 9353 | (48.6) | 3847 | (50.6) | 4012 | (51.1) | 1494 | (39.2) | ||
Female | 9904 | (51.4) | 3751 | (49.4) | 3837 | (48.9) | 2316 | (60.8) | ||
Educational attainment (years) | <0.001 | |||||||||
≥13 | 4259 | (22.1) | 1395 | (18.4) | 1820 | (23.2) | 1044 | (27.4) | ||
10–12 | 7450 | (38.7) | 2787 | (36.7) | 3022 | (38.5) | 1641 | (43.1) | ||
6–9 | 7033 | (36.5) | 3132 | (41.2) | 2833 | (36.1) | 1068 | (28.0) | ||
<6 | 236 | (1.2) | 144 | (1.9) | 76 | (1.0) | 16 | (0.4) | ||
missing | 279 | (1.4) | 140 | (1.8) | 98 | (1.2) | 41 | (1.1) | ||
Equivalent income (10,000 yen) | <0.001 | |||||||||
High (≥400) | 1819 | (9.4) | 715 | (9.4) | 685 | (8.7) | 419 | (11.0) | ||
Mid (200–399) | 6288 | (32.7) | 2323 | (30.6) | 2522 | (32.1) | 1443 | (37.9) | ||
Low (≤199) | 8023 | (41.7) | 3246 | (42.7) | 3402 | (43.3) | 1375 | (36.1) | ||
missing | 3127 | (16.2) | 1314 | (17.3) | 1240 | (15.8) | 573 | (15.0) | ||
Physical ability | ||||||||||
Stand up from the chair without any aids | <0.001 | |||||||||
Yes | 16,110 | (83.7) | 5995 | (78.9) | 6744 | (85.9) | 3371 | (88.5) | ||
No | 3027 | (15.7) | 1544 | (20.3) | 1063 | (13.5) | 420 | (11.0) | ||
missing | 120 | (0.6) | 59 | (0.8) | 42 | (0.5) | 19 | (0.5) | ||
Go up stairs without holding rail or wall | <0.001 | |||||||||
Yes | 11,626 | (60.4) | 4144 | (54.5) | 4986 | (63.5) | 2496 | (65.5) | ||
No | 7475 | (38.8) | 3389 | (44.6) | 2797 | (35.6) | 1289 | (33.8) | ||
missing | 156 | (0.8) | 65 | (0.9) | 66 | (0.8) | 25 | (0.7) | ||
IADL | <0.001 | |||||||||
Independent | 15,707 | (81.6) | 5691 | (74.9) | 6595 | (84.0) | 3421 | (89.8) | ||
Non-Independent | 3288 | (17.1) | 1772 | (23.3) | 1159 | (14.8) | 357 | (9.4) | ||
missing | 262 | (1.4) | 135 | (1.8) | 95 | (1.2) | 32 | (0.8) | ||
Self-recognition of forgetfulness | <0.001 | |||||||||
No | 16,252 | (84.4) | 6201 | (81.6) | 6736 | (85.8) | 3315 | (87.0) | ||
Yes | 2867 | (14.9) | 1347 | (17.7) | 1048 | (13.4) | 472 | (12.4) | ||
missing | 138 | (0.7) | 50 | (0.7) | 65 | (0.8) | 23 | (0.6) | ||
Present illness related to falls § | 0.001 | |||||||||
No | 12,746 | (66.2) | 5010 | (65.9) | 5117 | (65.2) | 2619 | (68.7) | ||
Yes | 6511 | (33.8) | 2588 | (34.1) | 2732 | (34.8) | 1191 | (31.3) | ||
The number of medications | <0.001 | |||||||||
None | 4116 | (21.4) | 1579 | (20.8) | 1682 | (21.4) | 855 | (22.4) | ||
<5 | 10,918 | (56.7) | 4051 | (53.3) | 4482 | (57.1) | 2385 | (62.6) | ||
≥5 | 3934 | (20.4) | 1821 | (24.0) | 1579 | (20.1) | 534 | (14.0) | ||
missing | 289 | (1.5) | 147 | (1.9) | 106 | (1.4) | 36 | (0.9) | ||
Frequency of physical activity | ||||||||||
Vigorous | 2 times a week or more | 2498 | (13.0) | 103 | (1.4) | 825 | (10.5) | 1570 | (41.2) | <0.001 |
Once a week | 938 | (4.9) | 51 | (0.7) | 298 | (3.8) | 589 | (15.5) | ||
Less than once a week | 1991 | (10.3) | 632 | (8.3) | 1004 | (12.8) | 355 | (9.3) | ||
None | 12,275 | (63.7) | 6309 | (83.0) | 4946 | (63.0) | 1020 | (26.8) | ||
missing | 1555 | (8.1) | 503 | (6.6) | 776 | (9.9) | 276 | (7.2) | ||
Moderate | 2 times a week or more | 9405 | (48.8) | 2118 | (27.9) | 4775 | (60.8) | 2512 | (65.9) | <0.001 |
Once a week | 1789 | (9.3) | 512 | (6.7) | 679 | (8.7) | 598 | (15.7) | ||
Less than once a week | 2953 | (15.3) | 1600 | (21.1) | 1012 | (12.9) | 341 | (9.0) | ||
None | 4247 | (22.1) | 2985 | (39.3) | 1058 | (13.5) | 204 | (5.4) | ||
missing | 863 | (4.5) | 383 | (5.0) | 325 | (4.1) | 155 | (4.1) | ||
Light | 2 times a week or more | 12,761 | (66.3) | 3748 | (49.3) | 5964 | (76.0) | 3049 | (80.0) | <0.001 |
Once a week | 1336 | (6.9) | 502 | (6.6) | 517 | (6.6) | 317 | (8.3) | ||
Less than once a week | 1599 | (8.3) | 955 | (12.6) | 481 | (6.1) | 163 | (4.3) | ||
None | 2662 | (13.8) | 1990 | (26.2) | 536 | (6.8) | 136 | (3.6) | ||
missing | 899 | (4.7) | 403 | (5.3) | 351 | (4.5) | 145 | (3.8) | ||
Depression | <0.001 | |||||||||
No | 12,414 | (64.5) | 4414 | (58.1) | 5222 | (66.5) | 2778 | (72.9) | ||
Mild | 3113 | (16.2) | 1503 | (19.8) | 1208 | (15.4) | 402 | (10.6) | ||
Moderate to severe | 987 | (5.1) | 582 | (7.7) | 324 | (4.1) | 81 | (2.1) | ||
missing | 2743 | (14.2) | 1099 | (14.5) | 1095 | (14.0) | 549 | (14.4) | ||
Frequency of meeting friends | <0.001 | |||||||||
4 times a week or more | 3266 | (17.0) | 1010 | (13.3) | 1273 | (16.2) | 983 | (25.8) | ||
2 or 3 times per week | 3815 | (19.8) | 1093 | (14.4) | 1443 | (18.4) | 1279 | (33.6) | ||
Once a week | 2424 | (12.6) | 876 | (11.5) | 1012 | (12.9) | 536 | (14.1) | ||
Several times per month | 4143 | (21.5) | 1735 | (22.8) | 1865 | (23.8) | 543 | (14.3) | ||
Several times per year | 3683 | (19.1) | 1755 | (23.1) | 1576 | (20.1) | 352 | (9.2) | ||
None | 1525 | (7.9) | 935 | (12.3) | 522 | (6.7) | 68 | (1.8) | ||
missing | 401 | (2.1) | 194 | (2.6) | 158 | (2.0) | 49 | (1.3) | ||
Social support | <0.001 | |||||||||
Yes | 18,914 | (98.2) | 7422 | (97.7) | 7727 | (98.4) | 3765 | (98.8) | ||
No | 343 | (1.8) | 176 | (2.3) | 122 | (1.6) | 45 | (1.2) | ||
Fall (n, multiple faller) | 887 | (4.6) | 456 | (6.0) | 327 | (4.2) | 104 | (2.7) | <0.001 |
Crude Model | Model 1 | Model 2 | ||||
---|---|---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Type of Exercise | ||||||
No Exercise (NE) | 1.47 (1.27–1.70) | <0.001 | 1.21 (1.04–1.40) | 0.016 | 1.23 (1.04–1.46) | 0.013 |
Individual Exercise (IE) | 1.00 Ref | 1.00 Ref | 1.00 Ref | |||
Group Exercise (GE) | 0.65 (0.52–0.81) | <0.001 | 0.75 (0.60–0.95) | 0.014 | 0.78 (0.61–1.00) | 0.048 |
Model 3 | Model 4 | Model 5 | ||||
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Type of Exercise | ||||||
No Exercise (NE) | 1.16 (0.99–1.35) | 0.062 | 1.21 (1.04–1.41) | 0.014 | 1.20 (1.03–1.40) | 0.019 |
Individual Exercise (IE) | 1.00 Ref | 1.00 Ref | 1.00 Ref | |||
Group Exercise (GE) | 0.78 (0.62–0.98) | 0.030 | 0.74 (0.59–0.94) | 0.011 | 0.75 (0.60–0.95) | 0.015 |
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Hayashi, T.; Kondo, K.; Kanamori, S.; Tsuji, T.; Saito, M.; Ochi, A.; Ota, S. Differences in Falls between Older Adult Participants in Group Exercise and Those Who Exercise Alone: A Cross-Sectional Study Using Japan Gerontological Evaluation Study (JAGES) Data. Int. J. Environ. Res. Public Health 2018, 15, 1413. https://doi.org/10.3390/ijerph15071413
Hayashi T, Kondo K, Kanamori S, Tsuji T, Saito M, Ochi A, Ota S. Differences in Falls between Older Adult Participants in Group Exercise and Those Who Exercise Alone: A Cross-Sectional Study Using Japan Gerontological Evaluation Study (JAGES) Data. International Journal of Environmental Research and Public Health. 2018; 15(7):1413. https://doi.org/10.3390/ijerph15071413
Chicago/Turabian StyleHayashi, Takahiro, Katsunori Kondo, Satoru Kanamori, Taishi Tsuji, Masashige Saito, Akira Ochi, and Susumu Ota. 2018. "Differences in Falls between Older Adult Participants in Group Exercise and Those Who Exercise Alone: A Cross-Sectional Study Using Japan Gerontological Evaluation Study (JAGES) Data" International Journal of Environmental Research and Public Health 15, no. 7: 1413. https://doi.org/10.3390/ijerph15071413