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 were associated with recurrent falls later in life.

Methods:

This study is a secondary analysis of prospectively collected 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). A sensitivity analysis repeated the primary models restricted to participants without a baseline history of recurrent falls.

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: 1.05-1.95; p = 0.024), whereas muscle performance measures were not significantly associated with falls in the primary analysis. The association between slower gait speed and recurrent falls remained significant in the sensitivity analysis. Over follow-up, muscle performance declined, whereas gait speed remained stable.

Conclusions:

Slower midlife gait speed was associated with higher odds of recurrent falls, suggesting that fall vulnerability may be detectable as early as midlife. Given the exploratory nature of this study, further studies are warranted to confirm these findings.