Do Falling Frequency and Neighborhood Environment Jointly Influence Physical Activity Behavior in Midlife and Older Adults?: A Longitudinal Investigation

<b>Objective:</b> Drawing upon the socio-ecological framework, this study examines whether the neighborhood environment moderates the relation between falling frequency and physical activity (PA) behavior among adults 55 years or older. <b>Methods:</b> At baseline, participants (<i>N</i> = 430) reported number of falls during the past 12 months and leisure-time PA during the past month. At follow-up, PA was assessed weekly using the Physical Activity Scale for Elderly for four consecutive weeks. We used the Bike Score^TM, Walk Score®, and Index of Relative Rurality to capture objective attributes of the neighborhood environment. <b>Results:</b> The relation between falling frequency and PA was negative and tended to be stronger for recurrent fallers who lived in a neighborhood environment that was less bikeable, less walkable, and more rural. <b>Discussion:</b> This study offers novel quantitative insights that underscore the importance of examining how personal and environmental factors combine to influence PA behavior in the context of fall prevention and management.