TY - JOUR
T1 - Longitudinal associations between serum 25-hydroxyvitamin D, physical activity, knee pain and dysfunction and physiological falls risk in community-dwelling older adults
AU - Balogun, Saliu
AU - Winzenberg, Tania
AU - Wills, Karen
AU - Scott, David
AU - Jones, Graeme
AU - Callisaya, Michele
AU - Aitken, Dawn
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Aims: To describe the longitudinal associations between physiological falls risk, and between-person and within-person effects of 25-hydroxyvitamin D (25OHD), physical activity (PA), knee pain and dysfunction in community-dwelling older people. Methods: Data for 1053 participants (51% women; mean age 63 ± 7.4 years) studied at baseline, 2.5, 5, and 10 years were analysed. Falls risk (Z-score) was measured using the Physiological Profile Assessment. Knee pain and dysfunction were assessed using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC). Moderate-to-vigorous PA (MVPA) was measured using accelerometer. Linear mixed-effect regression models, with adjustment for confounders, were used to estimate the association between physiological falls risk and between-person and within-person effects of PA, 25OHD and WOMAC score. Results: Between-person effects showed that 10-year average physiological falls risk was lower in participants who had a higher 10-year average 25OHD (β = −0.005 per nmol/l, 95% CI: −0.008, −0.002), log-MVPA (β = −0.16 per minute, 95% CI: −0.22, −0.10) and lower mean WOMAC score (β = 0.005 per-unit score, 95% CI: 0.003, 0.01). Within-person effects showed that a higher physiological falls risk at any time-point was associated with higher than average WOMAC score (β = 0.002 per-unit score, 95% CI: 0.0003, 0.004) and lower than average log-MVPA (β = −0.15 per minute, 95% CI: −0.24, −0.06), but not 25OHD, at the same time-point. Conclusion: Having higher WOMAC global score above an individual's average increases the risk of falling, whereas, increasing one's own MVPA level further reduces their risk of falling. The presence of between-person but not within-person associations for 25OHD suggests the former may be confounded by other factors.
AB - Aims: To describe the longitudinal associations between physiological falls risk, and between-person and within-person effects of 25-hydroxyvitamin D (25OHD), physical activity (PA), knee pain and dysfunction in community-dwelling older people. Methods: Data for 1053 participants (51% women; mean age 63 ± 7.4 years) studied at baseline, 2.5, 5, and 10 years were analysed. Falls risk (Z-score) was measured using the Physiological Profile Assessment. Knee pain and dysfunction were assessed using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC). Moderate-to-vigorous PA (MVPA) was measured using accelerometer. Linear mixed-effect regression models, with adjustment for confounders, were used to estimate the association between physiological falls risk and between-person and within-person effects of PA, 25OHD and WOMAC score. Results: Between-person effects showed that 10-year average physiological falls risk was lower in participants who had a higher 10-year average 25OHD (β = −0.005 per nmol/l, 95% CI: −0.008, −0.002), log-MVPA (β = −0.16 per minute, 95% CI: −0.22, −0.10) and lower mean WOMAC score (β = 0.005 per-unit score, 95% CI: 0.003, 0.01). Within-person effects showed that a higher physiological falls risk at any time-point was associated with higher than average WOMAC score (β = 0.002 per-unit score, 95% CI: 0.0003, 0.004) and lower than average log-MVPA (β = −0.15 per minute, 95% CI: −0.24, −0.06), but not 25OHD, at the same time-point. Conclusion: Having higher WOMAC global score above an individual's average increases the risk of falling, whereas, increasing one's own MVPA level further reduces their risk of falling. The presence of between-person but not within-person associations for 25OHD suggests the former may be confounded by other factors.
KW - Falls
KW - Pain
KW - Physical activity
KW - Vitamin D
UR - http://www.scopus.com/inward/record.url?scp=85041740693&partnerID=8YFLogxK
U2 - 10.1016/j.exger.2018.01.026
DO - 10.1016/j.exger.2018.01.026
M3 - Article
AN - SCOPUS:85041740693
VL - 104
SP - 72
EP - 77
JO - Experimental Gerontology
JF - Experimental Gerontology
SN - 0531-5565
ER -