The study’s findings are potentially important, for falls are the leading cause of fatal and non-fatal injuries in Americans aged 65 and older. Every 11 seconds, an older adult is treated in a U.S. hospital emergency department for a fall, and every 19 seconds, an older adult dies from a fall, the National Council on Aging reports.
Previous research has suggested that regular exercise can help increase older people’s mobility and thus, perhaps, their risk of falls. Those studies, however, tended to be short (less than a year long) or had other limitations that left their findings uncertain. As a result, many doctors have remained reluctant to “prescribe” exercise to their older patients out of concern that it might cause falls or other injuries, or lead to heart attacks, hospitalizations or even death.
The new study should help ease those concerns.
The study — a systematic review and meta-analysis — was conducted by a team of researchers at Toulouse University’s Institute of Aging in France. The researchers reviewed 46 previous studies from around the world that had investigated the effects of exercise on adults aged 60 and older. They included 40 of the studies, which had more than 21,000 participants, in their meta-analysis.
All the studies were randomized controlled trials (the gold standard of medical research), which meant they had randomly divided participants into at least two groups. One group was assigned an exercise intervention, and the other — the “control group” — was not. Each study lasted for at least a year.
The meta-analysis found that exercising was associated with “a modest but significant” reduction in the risk of falls. Across the studies, older people assigned to an exercise intervention experienced 12 percent fewer falls and 26 percent fewer falls resulting in injuries than their peers in the control groups.
Exercise also seemed to protect against fractures, although that finding was not statistically significant, say the meta-analysis’ authors.
In addition — and, perhaps, most important — the researchers found no link between exercising and an increased risk of hospitalization or death. In fact, a deeper dive into the data suggested that exercise might reduce the risk of early death in people with certain diseases, particularly heart disease and cognitive decline.
“Though far from conclusive, this is an intriguing finding which deserves follow-up,” write Drs. Ryan Kraemer and Seth Landefeld of the University of Alabama in an invited editorial that accompanies the study. “Furthermore, this is exactly the type of detailed information that clinicians need — patients with heart disease or cognitive impairment may benefit the most from exercise intervention.”
An exercise prescription
The meta-analysis has some limitations. Its results rely on the quality of the underlying studies and, as the researchers themselves point out, some of the studies did not have clearly reported data on how well their participants had adhered to the exercise regime. In addition, by only including studies in the meta-analysis that were at least 12 months long, the analysis may have missed one or more important studies with shorter follow-ups.
But, as Kraemer and Landefeld point out in their editorial, the meta-analysis’ findings “are remarkably similar to other systematic reviews of the effects of other exercise programs on falls and injurious falls” — a consistency that “increases confidence in the robustness of the findings.”
So, what do the findings say about the type and amount of exercise that appears to offer older people protection against falls?
Most of the exercise regimes in the studies involved more than one type of exercise, usually aerobics (such as walking or stationary cycling) plus strength or balance training. The activity was typically done three times a week in approximately 50-minute sessions and at moderate intensity.
“When it comes to long-term exercise for older adults, less is not always more,” write Kramer and Landefeld. “[M]oderate intensity exercise 2 or 3 times weekly should be what the doctor orders.”
FMI: You’ll find an abstract of the study and the editorial on JAMA Internal Medicine’s website, but, unfortunately, both papers are behind a paywall.