Cochrane review finds exercise best in fall prevention

Written by Danielle Barron Tuesday, 14 April 2009 15:52

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Clinical News

Exercise appears to be the most widely effective strategy for reducing both the risk of falling and the overall number of falls among older people, according to the latest Cochrane review.

Other measures, including pacemakers and vitamin D supplements, might be useful in preventing certain individuals from falling, but exercise programmes that lend strength, flexibility and balance appear to be one of the best ways to prevent falls, found the review.

 “It may not be possible to prevent falls completely, but people who tend to fall frequently may be enabled to fall less often,” said Dr Lesley Gillespie, an orthopaedic trauma specialist at the University of Otago in New Zealand and lead author of the review, which looked at over 100 studies.

“Falling puts a strain on the family and is an independent predictor of admission to a nursing home,” Dr Gillespie added.
Gillespie and colleagues examined 111 studies of falling prevention measures, which included more than 55,000 people from 15 countries. The studies suggest that group exercise programmes, Tai Chi and home exercise programs all reduce the risk of falls and the rate of falling.

Other preventive measures might only be effective for small, targeted groups, said Dr Gillespie.
“Taking vitamin D supplements probably does not reduce falls, except in people who have a low level of vitamin D in the blood,” she said.

Cataract surgery and insertion of a pacemaker can help specific groups of people with poor eyesight or certain blood pressure conditions fall less often, she added.

In some cases, gradually reducing the dosage of sleep aids and depression medicines can reduce the number of falls experienced by an individual, the researchers also found.
Dr Gillespie noted that the findings “may not be applicable to older people with dementia” since most of the studies in the review “specifically excluded them from participation.”