Falls are important causes of injury and mortality in older people, and associated medical costs can be enormous. Physical activity (PA) is a potential preventive factor for falls. However, few studies have examined the effect of different types of PA on fall prevention. This study aimed to evaluate the association between PA levels and the incidence of recurrent falls by type of PA in middle-aged and older people. This cohort study targeted 7,561 community-dwelling individuals aged 40–74 years who did not experience recurrent falls in the year before baseline. Information on PA levels, demographics, body size, lifestyle, and fall/disease history was obtained using a self-administered questionnaire in the baseline survey. Levels of total PA, leisure-time PA, and non-leisure-time PA (occupation, commuting, and housework) were estimated using metabolic equivalent (MET) scores (MET-h/day; hours spent on a given activity per day multiplied by its MET intensity). PA levels were categorized into four groups. Falls were recorded as none, once, or twice or more (recurrent falls). The outcome of the study was the incidence of recurrent falls in the past year before a survey conducted 5 years after the baseline survey. Logistic regression analyses were performed to calculate odds ratios for recurrent falls. Higher total PA and non-leisure-time PA levels were associated with a higher risk of recurrent falls (P for trend = 0.0002 and 0.0001, respectively), with the highest total PA and non-leisure-time PA groups having a significantly higher adjusted OR (1.96 [95%CI:1.33–2.88] and 2.15 [95%CI:1.48–3.14], respectively) relative to the lowest group (reference). As for leisure-time PA, the medium group had a significantly lower adjusted OR (0.70 [95%CI:0.49–0.99]) relative to the reference group. By sex, the adjusted OR in the medium leisure-time PA group was significantly lower relative to the reference group in women (0.50 [95%CI: 0.29–0.85]) but not in men. Medium level leisure-time PA reduces the risk of recurrent falls in middle-aged and older people, whereas higher level non-leisure-time PA is associated with a higher risk of recurrent falls.

中文翻译：

---

40-74 岁日本社区居民的体育活动和反复跌倒风险：村上隆队列研究

跌倒是老年人受伤和死亡的重要原因，相关的医疗费用可能是巨大的。体力活动 (PA) 是跌倒的潜在预防因素。然而，很少有研究检查不同类型的 PA 对预防跌倒的影响。本研究旨在评估 PA 水平与中老年人 PA 类型的复发性跌倒发生率之间的关联。该队列研究针对 7,561 名 40-74 岁的社区居民，他们在基线前一年没有经历过反复跌倒。使用基线调查中的自我管理问卷获得有关 PA 水平、人口统计、体型、生活方式和跌倒/疾病史的信息。总 PA、休闲时间 PA 和非休闲时间 PA（职业、通勤、和家务）是使用代谢当量（MET）评分（MET-h/day；每天花在给定活动上的时间乘以其 MET 强度）来估计的。PA水平分为四组。跌倒记录为无跌倒、一次跌倒或两次或多次跌倒（反复跌倒）。该研究的结果是在基线调查后 5 年进行的调查之前的过去一年中反复跌倒的发生率。进行逻辑回归分析以计算复发性跌倒的优势比。较高的总 PA 和非休闲时间 PA 水平与较高的复发性跌倒风险相关（趋势 P 分别 = 0.0002 和 0.0001），最高的总 PA 和非休闲时间 PA 组具有显着更高的调整后相对于最低组（参考）的 OR（分别为 1.96 [95%CI:1.33–2.88] 和 2.15 [95%CI:1.48–3.14]）。至于休闲时间 PA，相对于参考组，中等组的调整后 OR (0.70 [95%CI:0.49–0.99]) 显着降低。按性别划分，中等休闲时间 PA 组的调整后 OR 在女性中显着低于参考组（0.50 [95%CI: 0.29-0.85]），但在男性中则不然。中等水平的休闲时间 PA 可降低中老年人反复跌倒的风险，而较高水平的非休闲时间 PA 与较高的反复跌倒风险相关。