Evidence Summary
What is an Evidence Summary?
Key messages from scientific research that's ready to be acted on
Got It, Hide thisExercise 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
| Study population | Number of studies | Effect of exercise vs no exercise on rate of falls* |
| People living in the general community | 61 | There were about 21% fewer falls in the exercise groups. |
| People living in nursing homes or hostels | 14 | Groups did not differ for falls |
| People with Parkinson disease | 6 | There were about 53% fewer falls in the exercise groups. |
| People who had a stroke | 3 | Groups did not differ for falls |
| People with cognitive impairment | 3 | There were about 45% fewer falls in the exercise groups. |
| People discharged from hospital | 3 | Groups did not differ for falls |
*Rate ratio.
Related Topics
Glossary
Trouble remembering, learning new things, concentrating, or making decisions that affect everyday life.
Studies where people are assigned to one of the treatments purely by chance.
Related Evidence Summaries
-
Exercise alone, and in combination with different fall prevention strategies may lower the risk of falls leading to injuries in older adults 65 and over
JAMA: Journal of the American Medical Association (2017) -
Fall-prevention strategies based on individual patient needs may be better at reducing falls in acute-care settings
JBI Database of Systematic Reviews and Implementation Reports (2017) -
Interventions for preventing falls in older people living in the community
Cochrane Database of Systematic Reviews (2012)
Related Web Resources
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Too fit to fracture: Managing osteoporosis through exercise
Osteoporosis CanadaIf 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. -
Foot pain: When to see a doctor
Mayo ClinicIf you have foot pain due to an injury, it might respond well to rest and cold. Put ice on your foot for 15 to 20 minutes several times a day. You can also try anti-inflammatory medication. See a doctor right away if it is serious. -
Dementia and falls
Canadian Institute for Health InformationOlder adults with dementia have a higher risk of falls compared to other older adults. People with dementia are more likely to fall because of problems with mobility, balance and strength. Safety programs are available to help lower the amount of falls in older adults.
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