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STUDY: Preventing falls among older people is crucial
JOURNAL: British Medical Journal 2002;325:128-131
AUTHORS: Dr. Lesley Day
ABSTRACT: Healthy elderly people living on their own who exercised in a group weekly and on their own twice a week were less likely to fall, according to the results of an Australian study.
COMMENTARY: Preventing falls among older people is crucial for their health and ability to live independently, because falls often result in debilitating injuries such as hip fractures.
Dr. Lesley Day of Monash University in Victoria and colleagues randomly assigned 1,090 people aged 70 to 84 to an exercise program, home hazard management, vision improvement, or combinations of these interventions. The exercise component included a 1-hour weekly exercise class supplemented by daily home exercises. About one third of the exercises were designed to improve balance; flexibility and leg strength were also addressed.
At the end of 15 weeks, study participants who exercised showed improvements in thigh muscle strength, stability and balance. At the end of 18 months, the increase in muscle strength had disappeared, but improvements in balance remained.
Patients who exercised were 18% less likely to fall during the course of the study. While home hazard reduction or vision improvement alone did not prevent falls, study participants who completed all three interventions showed the most dramatic reduction in falls. Those who exercised and completed the home hazard and vision improvements were 33% less likely to fall during the study.
The investigators conclude that improved balance was behind the fall reduction among exercisers.
Compliance with home exercise was relatively poor, with participants working out an average of only twice weekly. This is the lowest intensity group-based exercise program shown to be effective in reducing falls among community-dwelling older people.
The Australian team estimated that 14 clients would need to receive the exercise intervention to prevent one fall annually. Only half that number would need to participate if all three components were included in the intervention.
Participation in an exercise intervention is appropriate for senior citizens living on their own, who are of relatively good health, and who have their family doctor's approval. She added that community agencies and local government organizations can deliver such interventions effectively.