Effectiveness of exercise on fall prevention in community-dwelling older adults: a 2-year randomized controlled study of 914 women

Author: Toni Rikkonen1, Reijo Sund1, Heli Koivumaa-Honkanen2,3, Joonas Sirola1,4, Risto Honkanen1, Heikki Kröger1,4
1 Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland Kuopio, Finland.
2 Institute of Clinical Medicine (Psychiatry), University of Eastern Finland, Kuopio, Finland.
3 Mental Health and Wellbeing Center, Kuopio University Hospital, Kuopio, Finland.
4 Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland.
Conference/Journal: Age Ageing
Date published: 2023 Apr 1
Other: Volume ID: 52 , Issue ID: 4 , Pages: afad059 , Special Notes: doi: 10.1093/ageing/afad059. , Word Count: 232

Communal exercise interventions may help prevent falls and injuries. However, pragmatic trials demonstrating the effectiveness of such strategies are sparse.

We determined whether a cost-free 12-month admission to the city's recreational sports facilities including initial 6 months of supervised weekly gym and Tai Chi sessions decreases the number of falls and related injuries. The mean (SD) follow-up time was 22·6 (4.8) months in 2016-19. A total of 914 women from a population-based sample with a mean age of 76.5 (SD 3.3, range 71.1-84.8) years were randomized into exercise intervention (n = 457) and control (n = 457) groups. Fall information was collected through biweekly short message (SMS) queries and fall diaries. Altogether 1,380 falls were recorded for the intention-to-treat analysis, with 1,281 (92.8%) being verified by telephone.

A 14.3% fall rate reduction was detected in the exercise group (Incidence rate ratio (IRR) = 0.86; CI 95% 0.77-0.95) compared with the control group. Approximately half of the falls caused moderate (n = 678, 52.8%) or severe (n = 61, 4.8%) injury. In total, 13.2% (n = 166) of falls (including 73 fractures) required medical consultation with a 38% lower fracture rate in the exercise group (IRR = 0.62; CI 95% 0.39-0.99). Overall, the greatest reduction of 41% (IRR = 0.59; CI 95% 0.36-0.99) was observed in falls with severe injury and pain.

A community-based approach for a 6-month exercise period combined with a 12-month free use of sports premises can reduce falls, fractures and other fall-related injuries in aging women.

Keywords: aging; exercise; fall injury; fall prevention; fracture; older people.

PMID: 37097767 DOI: 10.1093/ageing/afad059