Exercise for the prevention of falls in older adults: a meta-analysis

Over one-third of adults over the age of 65 experience at least one fall every year. Falls can result in injury, hospitalization, loss of independence, and mortality. Studies examining the effects of exercise on falls are effective in reducing the risk for falls, however they are highly variable in sample, intervention, and study design characteristics. The purpose of this meta-analysis was to provide an updated and comprehensive synthesis of the effects of exercise-based interventions on reducing the risk for falls in older adults. Medline, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Proquest were systematically searched through June of 2014 for studies targeting adults over the age of 60, included an exercise intervention, included a control or comparison group, reported falls, and was published after 1970 in the English language. Estimates of risk ratios were pooled across studies using a random-effects model of meta-analysis. 79 studies remained after screening and data extraction (17,863 participants). There was a 21.3% reduction in the risk for falls (RR=0.787 95% CI = 0.73, 0.85, p .001) and significant heterogeneity of variance (Q = 238.86, p .001, I2 = 67.35). This meta-analysis found evidence that exercise only interventions were more effective in reducing the risk for falls in older adults than multifactorial interventions. Future research on fall prevention exercise should incorporate accurate and frequent reporting of falls. Exercise interventions should last at least three months, include challenges to dynamic balance and incorporate strength and resistance, and should be progressive in intensity. Interventions should be structured and include frequent contact with exercise instructors to promote adherence, and include one-on-one instruction whenever possible.