Exercise reduces falling risk for older adults

Older adults who exercise may reduce their risk of falls by more than a third compared to sedentary peers, a research review suggests.

Workouts that focus on improving balance, coordination, mobility and flexibility all may help reduce the risk of falls more than getting no exercise at all, the study found. And getting a variety of different types of exercise may have the greatest effect, regardless of whether individuals start out with a low or high risk for falls.

“All older adults should be regularly undertaking exercises that safely challenge their balance to prevent falls,” said Cathie Sherrington of the University of Sydney in Australia, the study’s lead author.

“Frailer people should see a health professional for such exercise to be prescribed but fitter people can attend a local gym or community exercise class,” Sherrington said by email. “The trick is to find an exercise regimen that you enjoy and will stick too as it fits with your other priorities and commitments.”

The current study, published in the British Journal of Sports Medicine, updates findings Sherrington and colleagues reported earlier this year in the Cochrane Library journal, which analyzed results from randomized controlled trials through May 2018.

The new study includes findings from 25 countries, including results that weren’t available when the original came out, and provides more certainty about the effect of exercise on older adults, Sherrington said.

For the current analysis, researchers examined data from 59 trials with a total of almost 13,000 participants. They found with “high certainty” that exercise reduces the rate of falls by 23% among adults aged 60 and up.

The risk reduction with exercise was similar when researchers only looked at adults 75 and older, as well as when researchers looked only at people with a high risk for falls.

Balance and functional exercises - workouts designed to make people safer during daily activities like dressing and bathing - were associated with a 24% lower risk of falls, the study found.

And when people did multiple types of exercises - typically a mix of balance and functional workouts as well as resistance training to improve muscle strength - they had a 34% lower risk of falls than people who didn’t exercise.

Tai chi, a Chinese meditation practice that combines deep breathing and slow, fluid movements, was associated with a 19% lower risk of falling.

Workouts supervised by physical therapists or other health professionals appeared more effective at reducing the risk of falls than unsupervised exercise.

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

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.

The analysis also wasn’t designed to determine what exact exercises to do or how intensely or frequently people need to exercise for maximum fall-prevention benefits.

While exercise can help prevent falls, many other precautions also matter, said Dr. Eric Larson of the Kaiser Permanente Washington Health Research Institute in Seattle.

“Exercise, if you don’t already do so, is really valuable,” Lawson, who wasn’t involved in the study, said by email. “Aim for at least 30 minutes a day on most days - more might be better if it’s not too exhausting.”

Fall-proofing at home is also key, he said.

“Check for loose rugs, cords, and other items that you could trip on,” Lawson advised. “Get good lighting and, for nighttime, get motion lights near your bed, especially if you often go to the bathroom at night.”

Footwear matters, too.

“Avoid walking around barefooted or in stocking feet - a good tennis shoe is often safest of all shoes,” Larson added. “Don’t be too proud to use a cane or walker if your balance is poor and especially if you are prone to falling, and use the cane or walker to stay as physically active as possible.”