JMIR Publications

ABSTRACT

Background:

Falls are a major cause of morbidity in older adults, yet risk may begin to emerge earlier in midlife. Physical performance measures may identify early functional vulnerability associated with later-life health outcomes.

Objective:

This study examined whether midlife gait speed and muscle performance are associated with recurrent falls later in life. Secondary exploratory analyses evaluated associations with subjective age and self-rated health at follow-up.

Methods:

A retrospective longitudinal analysis used data from the Midlife in the United States (MIDUS) cohort. Independent adults aged 45-64 years at Wave 2 (2004-2009) who completed physical performance assessments were followed to Wave 3 (2013-2021) (n = 309). Baseline measures included gait speed from a 50-foot walk test, grip strength, sit-to-stand time, and calculated lower-extremity power. The primary analysis examined associations between baseline physical performance and recurrent falls at follow-up (≥2 falls in the previous 12 months). Secondary exploratory analyses examined associations with subjective age and self-rated health.

Results:

At follow-up, 20% of participants reported recurrent falls. Slower midlife gait speed was associated with higher odds of recurrent falls (OR = 1.43, 95% CI: 1.06-1.97; p = 0.021), whereas muscle performance measures were not significantly associated with falls. Faster gait speed was also associated with a younger subjective age at follow-up (β = -0.10, 95% CI: -0.20 to -0.006; p = 0.038). Over follow-up, muscle performance declined, whereas gait speed remained stable.

Conclusions:

These findings support slower gait speed in midlife as a potential early marker of future fall vulnerability. Assessing gait speed during midlife may help identify individuals at increased risk of recurrent falls before overt functional decline, providing an opportunity for earlier preventive intervention.