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Many types of workouts may reduce falls in older adults

(Reuters Health) – Older adults who get regular exercise are less likely to experience falls than their counterparts who are inactive, a research review suggests.

Workouts that focus on balance and functional training to improve stability and coordination are especially effective at reducing fall risk, the study team reports in the Cochrane Library.

While exercise has long been linked to a lower risk of falls and fractures in older adults, the current review aimed to measure exactly how much of a difference regular workouts make. Researchers examined data from 108 trials with more than 23,000 participants 65 and older; most of these trials randomly assigned participants to exercise groups or control groups of people who were inactive or doing minimal gentle activities not thought to reduce falls.

Over time, exercise reduced the rate of people falling by 23 percent, the analysis found. This means that in the course of a year, if there were 850 falls among 1,000 people who did no workouts to prevent falls, adding exercise would result in 195 fewer falls, researchers calculated.

Exercise also reduced the overall risk of one or more falls by 15 percent. Over a year, this means that if 480 people out of 1,000 who didn’t exercise experienced a fall, adding workouts would result in 72 fewer people having a fall.

“We can now conclude that there is ‘high certainty’ evidence that exercise prevent falls,” said lead study author Cathie Sherrington of the University of Sydney in Australia.

“Exercise programs carried out in group classes or done at home prescribed by a health professional (such as a physiotherapist) or a trained exercise leader were effective,” Sherrington said by email. “Exercises were mostly done while standing as this better enhances balance and the ability to do daily activities such as standing up from a low chair or climbing stairs, and some effective exercise programs also used weights to make the exercises harder.”

Programs involving multiple types of exercise – mostly focused on balance, stability and resistance training – probably reduce falls, and Tai Chi may also reduce falls, the analysis found.

Researchers didn’t have enough data to determine whether workouts that only involve resistance exercises, walking or dancing might reduce falls.

Exercise may, however, make it less likely that people who do fall suffer fractures, although there’s less evidence of this.

Participants in the analysis were 76 years old on average and most were women. They came from 25 different countries and had no recent history of hospitalization.

Most of the smaller studies in the analysis didn’t report the risk of fracture, hospitalization, medical attention or other adverse events associated with falls, the authors note. And the evidence that was reported was low quality, making it hard to draw firm conclusions.

The analysis also can’t answer some key questions for patients: what exact exercises to do, and how often and how intensely they need to work out for the best results, said Dr. Sharon Straus, director of geriatric medicine at the University of Toronto, who wasn’t involved in the review.

Still, exercise is a key component of fall prevention because it can strengthen muscles and improve balance, which makes falls less likely, Straus said. But it’s not the only thing patients can do to reduce their risk.

Hearing and vision checkups can help because impairments in these areas can make people less aware of their surroundings and more prone to falls, previous research has found. Home improvements to ensure there’s plenty of light, no loose carpets or railings, and no objects to trip over in the middle of rooms can also help make falls less likely, prior studies have also found.

“There are many risk factors for falls including environmental factors as well as vision impairment,” Straus said by email. “However, exercise is an intervention that everyone should consider, not just for the benefit of fall prevention but also for the heart health benefits and potential for impact on cognition.”

SOURCE: Cochrane Library, online January 31, 2019.

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