In older people living in aged care homes, exercise programs reduce falls by the end of the program but not after the program ends

Dyer SM, Suen J, Kwok WS, et al. Exercise for falls prevention in aged care: systematic review and trial endpoint meta-analyses. Age Ageing. 2023 Dec 1;52(12):afad217.

Review questions

In older people living in aged care homes, does exercise reduce falls? Does exercise still have an effect after it is stopped?

Background

Many older people have falls. Falls can lead to serious injury and affect a person’s quality of life. We know that exercise can prevent falls in older people who live in the community. This review looked at whether exercise programs can prevent falls in older people who live in aged care homes and whether effects continue after exercise programs are stopped.

How the review was done

The researchers did a systematic review of studies available up to December 2022. They found 19 randomized controlled trials that included 3202 people. Most people were 65 years of age or older, and most were women.

The key features of the studies were:

• people lived in aged care homes that provided nursing care;
• people were mobile enough to participate in easy exercises and could follow instructions;
• exercise programs were compared with no exercise or usual care;
• exercise programs were intended to reduce falls;
• most exercise programs were supervised and provided by physiotherapists, professional instructors, or researchers;
• exercise programs typically used a combination of exercises including strength and resistance training, gait and balance exercises, or functional training; some used a single exercise type, such as Tai Chi;
• most exercises were done for 30 to 60 minutes/session with 2 or 3 sessions/week; and
• most people did the exercise programs for 3 to 6 months.

What the researchers found

Compared with no exercise or usual care, exercise programs:

• reduced falls and number of people who fell by the end of the program; and
• did not reduce falls or number of people who fell at 3 to 12 months after the end of the program.

Evidence about the effects of exercise programs on risk for fractures was very low quality.

Conclusion

In older people living in aged care homes, exercise programs reduce falls by the end of the program, but the benefit is lost once the exercise program stops.

Exercise program vs. no exercise or usual care in older people living in aged care homes

*Based on rate ratio for number of falls and risk ratio for number of people who had a fall.