Prevention of falls in the elderly--a review.
The proportion of elderly in the society increases and fall frequency increases with advancing age. Fractures occur in up to 12% of falls in the elderly. Hence, the focus from osteoporosis prevention has shifted towards fall prevention. This review aimed at identifying fall preventive strategies effective in the aspect of fall reduction or reduction in the numbers of fallers based on randomized controlled trials (RCT) with individuals aged >60 years.
- Multicomponent training programs incorporating different exercise modalities (especially balance and strength training) seem to be most effective in fall prevention, reducing both the number of individuals that fall and the fall rate in fallers.
- Among specific type of exercises examined, Tai Chi seems to be the most effective single-training modality.
- Training programs including only gait and balance or functional training significantly reduce the rate of falls, but not the risk of falling.
- Walking should not be the only method since there is no fall-preventive effect in the elderly.
- The effect of physical training on fall risk seems to be lower in institutionalized individuals.
Currently there is strong evidence that both the number of falls and the number of fallers can be reduced by structured physical training interventions. The most effective training is conducted at a high amount and with a high frequency, consisting of a multicomponent training with at least two different exercise modalities (e.g. balance and strength) > from Karlsson et al., Osteoporos Int 24 (2013) 747-762. All rights reserved to Springer.
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