Association of Cardiovascular Disease and Physical Activity Phenotypes with Falls among Midlife and Older Adults: 2018 Behavioral Risk Factor Surveillance System

ABSTRACT Background The role of physical activity (PA) in mitigating fall risk among adults with cardiovascular disease (CVD) is unclear. Purpose We examined the associations of CVD–PA phenotypes with falls. Methods Adults ≥ 45 years (n = 295,282; N = 130,103,093) from the 2018 Behavioral Risk Factor Surveillance System who self-reported CVD, leisure-time PA, and falls were examined. The weighted prevalence ratio (PR) of any, recurrent, and injurious falls across CVD–PA phenotypes (no CVD–PA, no CVD–no PA, CVD–PA, CVD–no PA) was estimated. Results The likelihood of any, recurrent, and injurious falls was higher across unhealthier CVD–PA phenotypes in fully adjusted models. In the total sample, no CVD–no PA (PR: 1.30; 95% CI: 1.10, 1.50), CVD–PA (PR: 1.35; 95% CI: 1.10, 1.60), and CVD–no PA (PR: 1.39; 95% CI: 1.11, 1.67) phenotypes were more likely to report injurious falls than no CVD–PA phenotype. Discussion Engaging in leisure-time PA may be an important lifestyle strategy for fall prevention in midlife and older adults who are at risk of CVD. Translations to Health Education Practice Our findings could be useful for health education in providing evidence on future fall prevention programs in adults who are at risk for CVD and falls.