Levels of Accelerometer-Based Physical Activity in Older Adults With a Mismatch Between Physiological Fall Risk and Fear of Falling

We examined the associations between levels of accelerometer-based physical activity and the mismatch of physiological fall risk and fear of falling (FOF) in community-dwelling older adults. We assessed 123 participants who received 7-day wrist-worn accelerometry. Physiological fall risk was assessed using the portable BTrackS™ balance system and FOF was assessed using a short version of the Falls Efficacy Scale-International. Participants were categorized into four groups: rational (low FOF/normal balance), irrational (high FOF/normal balance), incongruent (low FOF/poor balance), and congruent (high FOF/poor balance). One third of older adults had a mismatch between their FOF and actual fall risk. Accelerometer-based moderate to vigorous physical activity (MVPA) was significantly different in the irrational group compared to the rational group (p = 0.023) and the congruent group compared to the rational group (p = 0.032). Encouraging older adults to improve MVPA may prevent them from shifting from rational to irrational or congruent groups, thereby reducing the risk of injurious falls.