In the Journals

Long-term exercise reduces risk for falls among elderly

Older adults participating in exercise interventions lasting at least 1 year demonstrated significantly lower odds of falls and injurious falls, according to findings published in JAMA Internal Medicine.

“Long-term exercise benefits on prevalent adverse events in older populations, such as falls, fractures, or hospitalizations, are not yet established or known,” Philipe de Souto Barreto, PhD, from the Institute of Ageing at Toulouse University Hospital, France, and colleagues wrote.

De Souto Barreto and colleagues performed a systematic review and meta-analysis of 86 randomized controlled trials to determine if long-term exercise interventions lasting 1 year or longer improve the risk of falls, injurious falls, multiple falls (two or more), fractures, hospitalization and mortality in adults aged 60 years or older (n = 44,577; mean age, 73.1 years; 66.3% women).

The most common exercise intervention was multicomponent training, such as aerobics combined with strength and balance. The mean frequency of the interventions was three times per week for approximately 50 minutes per session at a moderate intensity. In the studies, active controls were often used as comparators.

The researchers found a significant association between exercise and reduced risk of falls (20 randomized controlled trials [RCTs] with 4,420 participants; RR = 0.88; 95% CI, 0.79-0.98) and injurious falls (9 RCTs with 4,481 participants; RR = 0.74; 95% CI, 0.62-0.88). Exercise interventions also reduced the risk for fractures (19 RCTs with 8,410 participants; RR = 0.84; 95% CI, 0.71-1).

Conversely, there was no significant association between exercise and reduced risk for multiple falls (13 RCTs with 3,060 participants), hospitalization (12 RCTs with 5,639 participants) and mortality (29 RCTs with 11,441 participants).

Similar results were observed in sensitivity analyses. However, there was significant association between exercise and reduced risk of fracture in the fixed-effect meta-analysis.

Meta-regression data indicated that exercising two to three times per week is the optimal duration.

“Long-term exercise, particularly moderate intensity, multicomponent training with balance exercises, performed two to three times per week, appears to be a safe and effective intervention for reducing the risk of being a faller/injurious faller in older populations,” de Souto Barreto and colleagues concluded.

In a related editorial, Ryan R. Kraemer, MD, and C. Seth Landefeld, MD, both from the University of Alabama at Birmingham, wrote that the findings by de Souto Barreto and colleagues add to the growing evidence that exercise interventions prevent adverse events, such as falls, in older people.

“Although we do not know whether it is best to combine aerobic exercise with strength training and balance training, there is substantial evidence that combining these exercise regimens is beneficial and we recommend prescribing such multicomponent regimens when they are available,” they wrote. “When it comes to long-term exercise for older adults, less is not always more: moderate intensity exercise two or three times weekly should be what the doctor orders.” – by Alaina Tedesco

 

Disclosures: de Souto Barreto reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.

Older adults participating in exercise interventions lasting at least 1 year demonstrated significantly lower odds of falls and injurious falls, according to findings published in JAMA Internal Medicine.

“Long-term exercise benefits on prevalent adverse events in older populations, such as falls, fractures, or hospitalizations, are not yet established or known,” Philipe de Souto Barreto, PhD, from the Institute of Ageing at Toulouse University Hospital, France, and colleagues wrote.

De Souto Barreto and colleagues performed a systematic review and meta-analysis of 86 randomized controlled trials to determine if long-term exercise interventions lasting 1 year or longer improve the risk of falls, injurious falls, multiple falls (two or more), fractures, hospitalization and mortality in adults aged 60 years or older (n = 44,577; mean age, 73.1 years; 66.3% women).

The most common exercise intervention was multicomponent training, such as aerobics combined with strength and balance. The mean frequency of the interventions was three times per week for approximately 50 minutes per session at a moderate intensity. In the studies, active controls were often used as comparators.

The researchers found a significant association between exercise and reduced risk of falls (20 randomized controlled trials [RCTs] with 4,420 participants; RR = 0.88; 95% CI, 0.79-0.98) and injurious falls (9 RCTs with 4,481 participants; RR = 0.74; 95% CI, 0.62-0.88). Exercise interventions also reduced the risk for fractures (19 RCTs with 8,410 participants; RR = 0.84; 95% CI, 0.71-1).

Conversely, there was no significant association between exercise and reduced risk for multiple falls (13 RCTs with 3,060 participants), hospitalization (12 RCTs with 5,639 participants) and mortality (29 RCTs with 11,441 participants).

Similar results were observed in sensitivity analyses. However, there was significant association between exercise and reduced risk of fracture in the fixed-effect meta-analysis.

Meta-regression data indicated that exercising two to three times per week is the optimal duration.

“Long-term exercise, particularly moderate intensity, multicomponent training with balance exercises, performed two to three times per week, appears to be a safe and effective intervention for reducing the risk of being a faller/injurious faller in older populations,” de Souto Barreto and colleagues concluded.

In a related editorial, Ryan R. Kraemer, MD, and C. Seth Landefeld, MD, both from the University of Alabama at Birmingham, wrote that the findings by de Souto Barreto and colleagues add to the growing evidence that exercise interventions prevent adverse events, such as falls, in older people.

“Although we do not know whether it is best to combine aerobic exercise with strength training and balance training, there is substantial evidence that combining these exercise regimens is beneficial and we recommend prescribing such multicomponent regimens when they are available,” they wrote. “When it comes to long-term exercise for older adults, less is not always more: moderate intensity exercise two or three times weekly should be what the doctor orders.” – by Alaina Tedesco

 

Disclosures: de Souto Barreto reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.