Meta-analysis: long-term exercise cuts fall, injury risk in elders

  • de Souto Barreto P & al.
  • JAMA Intern Med
  • 28 Dec 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Long-term exercise training (duration ≥1 year) in older adults is associated with reduced risk for falls, injurious falls, and possibly fractures, according to a large meta-analysis.
  • No benefits were found for reducing hospitalization or mortality.

Why this matters

  • This is the first meta-analysis to examine the effect of long-term exercise on prevalent adverse events in older adults.

Study design

  • Meta-analysis of 40 randomized controlled trials (RCTs; n=21,868) in adults aged ≥60 years.
  • Most trials had active comparator groups (attention controls to more intensive activities).
  • Funding: None disclosed.

Key results

  • The most frequent intervention was multicomponent training with aerobic plus strength and balance of moderate intensity, 3 times per week, at 50 minutes/session.
  • Exercise training was associated with lowered risk for falls (20 RCTs; risk ratio [RR], 0.88; 95% CI, 0.79-0.98; I2, 50.7%) and injurious falls (9 RCTs; RR, 0.74; 95% CI, 0.62-0.88; I2, 40.2%), and it tended to reduce the risk for fractures (19 RCTs; RR, 0.84; 95% CI, 0.71-1.00; I2, 0%).
  • Exercise training was not associated with reduced risk for hospitalizations or mortality.
  • The optimal frequency of exercise for mortality and falls appears to be 2-3 times per week, according to metaregression.

Limitations

  • Several RCTs failed to report adherence.
  • Moderate heterogeneity.
  • No subgroup analysis.