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Exercise
is safe bet to prevent falls in Older People
Newswise — Exercise programs that lend strength,
flexibility and balance might be one of the
best ways to prevent falls among people age
65 and older, according to a Cochrane review
of more than 100 studies.
A variety of other measures — from pacemakers to vitamin D
supplements — might be useful in preventing
certain individuals from falling, but
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.
“It may not be possible to prevent falls completely, but
people who tend to fall frequently may be
enabled to fall less often,” said Lesley
Gillespie, an orthopedic trauma specialist
at the University of Otago in New Zealand
and lead author of the review.
The review appears in the latest issue of The Cochrane
Library, a publication of The Cochrane
Collaboration, an international organization
that evaluates medical research. Systematic
reviews like this one draw evidence-based
conclusions about medical practice after
considering both the content and quality of
existing medical trials on a topic.
Each year, about 30 percent of people over age 65 who live
outside of assisted care facilities
experience a fall. Poor balance, diminished
eyesight, the side effects of medications
and dementia are among the reasons older
people sometimes fall.
One in five of these falls could require medical attention,
but even without causing serious injury,
falling can make individuals fearful of
leaving their homes or participating in
activities, the Cochrane researchers noted.
“Falling puts a strain on the family and is an independent
predictor of admission to a nursing home,”
Gillespie said.
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
programs, Tai Chi and home exercise programs
all reduce the risk of falls and the rate of
falling.
“Effective exercise programs for reducing falls focus on
balance, strength and flexibility, and
challenge the older adults to improve in all
of these components,” said Bonita Lynn
Beattie, a physical therapist and vice
president for injury prevention at the
Center for Healthy Aging. She suggested that
older adults should check in with their
primary doctor before beginning an exercise
program, especially if they “have
significant weakness, balance issues or
dizziness.”
Other preventive measures might only be effective for
small, targeted groups. For instance,
“taking vitamin D supplements probably does
not reduce falls, except in people who have
a low level of vitamin D in the blood,”
Gillespie said. Similarly, cataract surgery
and insertion of a pacemaker can help
specific groups of people with poor eyesight
or certain blood pressure conditions fall
less often.
Anti-slip devices worn on shoes during icy conditions and
reviewing medications regularly are also
effective in reducing falls. 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 found.
Behavioral changes can also make a difference, Beattie
said. “An older adult should probably
reconsider climbing on a ladder to clean
gutters or using a chair to change a light
bulb or reach high shelves,” she said.
Gillespie said 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.”
The Cochrane Collaboration is an international nonprofit,
independent organization that produces and
disseminates systematic reviews of health
care interventions and promotes the search
for evidence in the form of clinical trials
and other studies of interventions. Visit
http://www.cochrane.org for more
information.
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