Exercise helps prevent falls in older adults with cognitive impairment  

Chan WC, Fai Yeung JW, Man Wong, et al. Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: A systematic review and meta-analysis JAMDA. 2015;16:149-154.

Review question

Does exercise help prevent falls in older adults with a cognitive impairment like dementia?

Background

People with a cognitive impairment are more likely to fall and get hurt than older individuals that are cognitively healthy. Exercise can help prevent falls in cognitively healthy individuals but there has not been a lot of research measuring whether exercise has the same effect for older adults with a cognitive impairment.

How the review was done

This review included 7 randomized control trials with a total of 781 participants. Participants were included if they had a cognitive impairment or had been diagnosed with dementia. The mean age of participants in each of the studies was at least 78 years.  Exercise programs varied, but all included balance and strength training; other also included flexibility, walking and/or coordination training.  Programs were held at least 2x/week for at least 45 minutes. Three programs took place over a 12 month period; the others were for shorter periods of time (3-6mos). The studies compared group exercise programs to routine care or other activities such as flexibility and relaxation, a seated activities program and a light weight lifting exercise program. The review compared the number of falls between groups to look at the effect of physical exercise on falls prevention.

What the researchers found

Physical exercise programs help reduce the risk of falls for older adults with a cognitive impairment. Due to the small number of studies on this topic and the different levels of cognitive function between participants, more research is needed on how to design falls-prevention programs for older adults with cognitive impairment.  Future research should explore best ways to deliver programs, how often programs should take place and what level of intensity is necessary to help prevent falls.  The authors note that a one-size-fits-all solution is not likely, or even helpful, since programs depend on the needs and abilities of each older adult and are often adjusted as individual needs change.  The most effective exercises for falls prevention are tailored to individual needs.

Conclusion

Physical exercise programs – particularly those tailored to individual needs – can help reduce the risk of falls for older adults with a cognitive impairment.