Exercise may help prevent falls in elderly people
Elderly people are at greater risk of falling and subsequent injuries than younger adults. Research has shown that exercise and modifications to the home environment are effective methods of reducing the number of falls among elderly people. Now, research recently published in BMJ (formerly the British Medical Journal ) suggests that exercise is the single most effective measure for reducing falls in the home among elderly people. In this study, researchers compared an exercise program with home modification and vision care.
About the study
Australian researchers studied 1090 men and women aged 70 or older who lived in their own homes in an urban community of Melbourne, Australia. All participants reported being in good or excellent health at the start of the study and had the approval of their doctors to participate. People were excluded from this study if they had participated in balance-promoting physical activity in the last two months, could not walk a short distance without rest or help, or had severe respiratory or cardiac disease or a psychiatric illness.
At the start of the study, participants were interviewed in their homes about their ability to perform activities of daily living, social outings, falls, overall health, and medical history, including medications. During this home visit, the interviewer also assessed home hazards and participants’ leg strength, balance, and vision. Participants were given a calendar on which to record any falls.
Participants were then randomly assigned to one of eight groups:
- Exercise – weekly, one-hour exercise class (including balance-promoting exercise) for 15 weeks, plus daily exercises to do at home
- Home modification – assessment of fall hazards in the home and removal of those hazards
- Vision care – referral for vision care (for those with a vision problem) or an eye care brochure for those without need of vision correction
- Exercise and home modification
- Exercise and vision care
- Home modification and vision care
- Exercise, home modification, and vision care
- No intervention (control group)
After 18 months, researchers compared the annual number of falls among the eight groups. They also assessed any changes in strength, balance, and vision from the beginning to the end of the study, and compared these among the eight groups.
People in the group that combined exercise, home modification, and vision care had a 33% lower fall rate than those who received no intervention. It seems that exercise was the key to reducing the fall rate, because people in the home modification-only or vision care-only groups (and the two combined) did not have a lower fall rate than people in the control group. However, the exercise-only group did have an 18% lower fall rate than the control group.
Although these results are interesting, this study has its limitations. Most participants in this study were between the ages of 70 and 84, and all reported good or excellent overall health. Therefore these results may not apply to people 85 and older or to people who are in poorer overall health. Although participants were supposed to do the home exercises daily, most reported doing them only twice weekly. While this implies that even relatively infrequent exercise is beneficial, it also suggests that more exercise might further reduce the risk of falling. Similarly, it’s possible that a different type of home modification program or vision program could produce more beneficial results. Also, while falling is troublesome, the real problem is what happens to older adults when they fall. The study did not measure the complications associated with falling.
How does this affect you?
Should you be exercising if you are over age 70? Absolutely—with the approval of your physician, of course. This study suggests that exercise can reduce your risk of falling, which in turn reduces your risk of injury, hospitalization, and death.
In addition to reducing your risk of falling, exercise helps keep your heart healthy, your weight in control, and your body strong. And most people find that exercise increases their energy levels—a common concern for older people.
If you’re over 70 and want to begin an exercise program for the first time, talk with your health care provider about what type of program would be appropriate for you. And ask for a referral to a certified athletic trainer or physical therapist who can help you develop an exercise program that meets your needs.
Day L, et al. Randomised factorial trial of falls prevention among older people living in their own homes. BMJ . July 20, 2002;325:128-131.
Last reviewed Jul 24, 2002 by ]]>Richard Glickman-Simon, MD]]>
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