gms | German Medical Science

Physical activity and successful aging
10th International EGREPA Conference

European Group for Research into Elderly and Physical Activity

14.09. - 16.09.2006 in Köln

Preventing falls in older people? The role of exercise

Meeting Abstract

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Physical activity and successful aging. Xth International EGREPA Conference. Cologne, 14.-16.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06pasa004

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Veröffentlicht: 18. Dezember 2006

© 2006 McMurdo.
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Falls amongst older people are common, and the risk of falling increases with age. Although only a minority of falls result in serious physical injury, the consequences of falls have a major impact on both health and social care budgets. The last decade has seen a burgeoning of good quality evidence on how to prevent falls. As the risk of an individual falling is multifactorial, then intervening against multiple risk factors is conceptually attractive, and the evidence for the effectiveness of such an approach is good. Effective prevention involves identifying and modifying, where possible, risk factors for falls. Common modifiable risk factors include muscle weakness, problems with balance gait or stability, multiple drug therapy, postural hypotension, and cardiac disorders.

As muscle weakness and postural instability underlie many falls in older people, there has been much research activity assessing the potential that exercise might reduce falls. The role of exercise in fall prevention has been the source of much confusion and misunderstanding. This is because it is often forgotten that the effect of any exercise is specific to the type of exercise being undertaken. Accordingly, it has become clear that only a very highly specific type of exercise is effective in preventing falls: individually tailored, home based, one-to-one, professionally prescribed, progressive muscle strengthening and balance retraining combined with a walking plan [1], [2]. General exercise programmes, including seated exercise have not been shown to be effective in reducing falls.

Clinical trials report only modest reductions in falls, usually less that 35% in the number of people falling and in the number of falls [3]. While this is a worthwhile reduction, some falls in older people are not preventable. In our enthusiasm to reduce falls, we must ensure that the autonomy of old people is not compromised. Older people should be encouraged to walk and be active and take reasonable risks. After all a risk-free life is no life at all.


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