Exercises for seniors to improve balance and prevent falls
Working Out Cuts Seniors' Falls
Home safety interventions also reduced seniors' risk factor for falling.
By Kristina Fiore, MedPage Today
Medically Reviewed by Robert Jasmer, MD
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THURSDAY, Sept. 13, 2012 (MedPage Today) —Exercise programs, whether done in a group or at home, can lower the risk of falling among elderly patients, a large systematic review and meta-analysis showed.
Group exercise lowered fall risk by 15 percent and at-home physical activity reduced it by 22 percent, Lesley Gillespie, MD, of the Univeristy of Otago in Dunedin, New Zealand, and colleagues reported inCochrane Reviews.
With nearly a third of elderly patients susceptible to falls each year, researchers have been interested in determining which prevention programs are effective at reducing fall risk.
Gillespie and colleagues reviewed data on 79,193 patients in 159 trials that looked at various strategies, from exercise and vitamin D supplementation to home-safety interventions.
They found that multiple-component group exercise programs significantly reduced both the rate of falls and the risk of falling.
Multiple-component home-based exercise also reduced both the rate of falls and the risk of falling.
Multifactorial interventions — such as an individual risk assessment that looks at the patient's risk of falling and implements strategies to reduce specific risks — reduced the rate of falls, but not the risk of falling, the researchers reported.
Home safety interventions also reduced the rate of falls as well as the risk of falling, although they appeared to be more effective in people at higher risk of falling and when delivered by an occupational therapist, the researchers wrote.
On the other hand, vitamin D supplementation didn't have an impact on fall rates or risk — although it may be helpful in patients who have lower levels of the vitamin to begin with, they noted.
And treating vision problems actually increased both the rate and risk of falls, potentially because of the time needed to adjust to new glasses or major changes in prescription, the researchers reported.
One trial did find, however, that having a first cataract surgery reduced the rate of falls among older women, but a second cataract surgery did not.
A single trial also found that gradually withdrawing psychotropic medications reduced the rate of falls but not the risk of falling, and the researchers called the evidence supporting these interventions "limited."
Evidence from three of the trials suggested that pacemakers in patients with carotid sinus hypersensitivity reduced the rate of falls.
Evidence is also limited regarding the effects of educational materials alone on the risk of falling, the researchers wrote.
They added that among the 13 trials looking at cost, three programs showed cost savings: home-based exercise in patients older than 80, home safety interventions in those who've fallen previously, and a multi-factorial program that targeted eight specific risk factors.
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