Elders Who Walk Out Of Necessity Rather Than Recreation Suffer More Falls

Dr. Wenjun Li , PhD Health Statistics and Geography Lab Division of Preventive and Behavioral Medicine University of Massachusetts Medical School, Worcester. MedicalResearch.com: Interview with:
Dr. Wenjun Li , PhD
Health Statistics and Geography Lab
Division of Preventive and Behavioral Medicine
University of Massachusetts Medical School, Worcester.

Medical Research: What are the main findings of the study?

Dr. Wenjun Li: Compared to those walking for recreational purposes only, older adults walking for utilitarian purposes had higher risk for outdoor falls and fall-related injuries that require medical attention.

Medical Research: Were any of the findings unexpected?

Dr. Wenjun Li: We first thought the higher risks for outdoor fall injuries among utilitarian walkers could be explained by their higher frequency and duration of walking compared to recreational walkers. However, the data surprised us: on average, utilitarian walkers walked far less number of blocks per week compared to recreational walkers, yet their risk for serious fall injuries were nearly four times higher. We also thought the utilitarian walkers might be sicker or have more physical limitations than recreational walkers, we did not find any notable difference. These lead us to think: perhaps outdoor walking environment played an important role, which needs to be investigated.

Medical Research: What should clinicians and patients take away from your report?

Dr. Wenjun Li: First, we need to know that the effects of utilitarian and recreational walking on risk of fall injuries are different. When recommending walking exercise to older adults, one may need to consider whether the elder lives in a neighborhood with safe walking environment. For frail elders living in a neighborhood without a good walking environment, recommending recreational walking in safe walking environment is a good one; however, I have reservations about recommending utilitarian walking. More studies are needed to help us understand the problem and make more useful recommendations.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Wenjun Li: It would be extremely important to investigate personal as well as environmental determinants of elder’s choice of routes for utilitarian vs. recreational walking, and how they interact with their neighborhood environment. Much of our current studies are on associations of health behaviors and outcomes with environment, and little attention on how the individuals actually interact with his/her living environment. We have designed a new study to investigate this issue, and submitted a grant application to NIH for consideration of funding. We also welcome private research foundations to support us to continue this important work.


Wenjun Li, Elizabeth Procter-Gray, Lewis A. Lipsitz, Suzanne G. Leveille, Holly Hackman, Madeleine Biondolillo, and Marian T. Hannan. (2014). Utilitarian Walking, Neighborhood Environment, and Risk of Outdoor Falls Among Older Adults. American Journal of Public Health. e-View Ahead of Print.

doi: 10.2105/AJPH.2014.302104