Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Long-term exercise reduces falls, but not hospitalization or death, in older people

de Souto Barreto P, Rolland Y, Vellas B, et al. Association of Long-term Exercise Training With Risk of Falls, Fractures, Hospitalizations, and Mortality in Older Adults: A Systematic Review and Meta-analysis. JAMA Intern Med. 2018 Dec 28. [Epub ahead of print]

Review question

In older people, does exercise training for at least 1 year reduce risk for falls, falls that cause injuries, fractures, hospitalization, or death?


People 65 years of age and older are more likely to experience falls, injuries from falls, broken bones, hospitalization, and even death. It is unclear whether exercise can help reduce the risk for these events.

How the review was done

The researchers did a systematic review based on studies available up to March 2018. They found 46 randomized controlled trials with 22,709 people.

The key features of the RCTs were:

·        average age was 73 years, 66% were women, and most lived in the community;

·        most trials included multiple types of exercise, such as aerobic exercise plus strength training plus balance training;

·        exercise was usually about 3 times per week for 50 minutes at a moderate intensity;

·        exercise was often in a group-based supervised format or a mix of group-based with home-based unsupervised exercises;

·        exercise continued for an average of a year and half; and

·        studies usually compared exercise with other treatments.

What the researchers found

Compared with control groups, exercise:

  • reduces risk for falls by about 12%;
  • reduces risk for falls that cause injuries by about 26%;
  • did not reduce risk for fractures;
  • did not reduce risk for hospitalization; and
  • did not reduce risk for death.


In older people, long-term exercise training reduces risk for falls and falls that cause injuries but not fractures, hospitalization, or death.

Long-term exercise vs control in older people


Number of trials (and people)

Effect of exercise


20 trials (4420 people)

About 5 fewer people out of 100 would fall.

Falls that cause injuries

9 trials (4481 people)

About 4 fewer people out of 100 would fall.


19 trials (8410 people)

Groups did not differ for fractures.


12 trials (5939 people)

Groups did not differ for hospitalizations.


29 trials (11,441 people)

Groups did not differ for deaths.



Control group
A group that receives either no treatment or a standard treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

  • Dance therapy for people with cancer

    Evidently Cochrane
    Dance therapy does not appear to have a large benefit on improving physical or psychological symptoms of people with cancer, such as depression, fatigue or body image. However, you should dance if it helps you feel better.
  • After a stroke: Does fitness training improve health and mobility?

    Informed Health Online
    Fitness training after a stroke can improve physical fitness and mobility, but can require a lot of effort and motivation. Examples of fitness training include Nordic walking, treadmills, or exercise bikes.
  • Too fit to fracture: Managing osteoporosis through exercise

    Osteoporosis Canada
    If you have osteoporosis, it is recommended to exercise regularly. A physical therapist or kinesiologist can give you advice on what type of exercise is best for you. You should do a combination of strength, posture, balance, and aerobic exercise.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use