Exercise can prevent falls in older people

Sherrington C, Michaleff ZA, Fairhall N, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2016 Oct 4. [Epub ahead of print]

Review question

Does exercise prevent falls In older people?

Background

Injuries from falls are common among older people. While many falls cause little or no harm, some result in broken bones, long-term pain, disability, hospitalization, and even death.

How the review was done

The reviewers found 88 studies (randomized controlled trials) of exercise programs that were published up to January 2016.

The studies included 19,478 people 65 years of age and older. They took place in in the general community (61 studies), nursing homes (10 studies) and hostels (4 studies), or included people with Parkinson disease (6 studies), stroke (3 studies), cognitive impairment (3 studies), or people recently discharged from hospital (3 studies).

Studies compared an exercise program with no exercise. The intensity or type of exercise was tailored to the individual people in 51 of the studies. Exercise in small groups of fewer than 10 participants was supervised by an instructor in 44 of the studies.

People were followed for an average of 25 to 51 weeks.

What the researchers found

People in the exercise groups had fewer falls than people in the no exercise groups in studies of those living in the general community, with Parkinson disease, or with cognitive impairment.

There were no differences in falls between exercise and no exercise in studies of people living in nursing homes or hostels, people with stroke, or those recently discharged from hospital.

The most successful exercise programs for people living in the community were those that included 3 or more hours of exercise per week and that had a high challenge to balance (e.g., standing with both legs close together, with one foot in front of the other, or on one leg; reaching, shifting body weight from one leg to another, or stepping onto a higher surface; or standing without using arms for support or holding onto a surface with only one hand or one finger instead of the whole hand).

Conclusion

Exercise programs can reduce falls compared with no exercise in older adults living in the community, with Parkinson disease, or with cognitive impairment.

Exercise vs no exercise in older adults

*Rate ratio.