Fewest falls were attributable to faster walking speed (0.01%), high physical activity (0.7%), going outdoors frequently or KPT-8602 infrequently (1.1%), use of AED (1.7%), and use of antidepressants (2.0%). Fig. 3 Population attributable risk in older community-dwelling women Discussion In this 4-year prospective study of 8,378 community-dwelling older women, we identified independent associations of physical and lifestyle factors on fall rates. Lifestyle factors are possible markers of exposure to environmental hazards and engagement in riskier activities. For example, a relationship of more falls and high physical activity (involving recreational activity,
blocks walked, and stair climbing) was dependent on the presence of IADL impairment, potentially indicating risk-taking. Five potentially modifiable physical risk factors, including poor standing balance, fear of falling, IADL impairment, dizziness upon selleck chemicals llc standing, and poor visual acuity, each contributed to at least 5% of falls among older community-dwelling women and fall history to 28%. The physical risk factors identified are consistent with those reported in prior observational studies: poor visual acuity , IADL impairment [26, 27], poor standing balance , fear of falling , use of AED, antidepressants, and benzodiazepines [8, 10, 28], dizziness upon standing [1, 27], self-rated health, and fall history [9, 27, 29]. In the
laboratory, fear of falling is associated with poor balance  and ineffective recovery strategies during an unexpected perturbation . Fear of falling may also lead to reduced social contacts . Reduced social contacts with family members is associated with more falls , possibly due to
a lack of educational and physical resources that reduce participation in riskier activities and/or increase home safety environmental modifications. Thus, fear of falling may have physical as well as behavioral and environmental components. Since falls are multifactorial, fall history is probably a marker for having multiple risk factors. Usual-walking speed and body height were considered as physical factors; however, their independent associations with falls after adjusting with physical function suggests they may have a behavioral and/or environmental component. An association of faster usual-walking Tryptophan synthase pace and more falls is consistent with laboratory studies indicating that compared to slow walking, fast walking is associated with a higher likelihood of a fall in the event of a trip  due to increased anterior body rotation following a trip. Shorter body height was associated with more falls. Shorter legs may result in having less favorable stepping trajectories needed for clearing a given size obstacle. A shorter reach, in a maladapted setting, may contribute to risk-taking out of necessity, such as standing on stools or chairs and reaching beyond one’s center of mass in order to maintain independence in the community.