Exercise Reduced Rate of Injurious Falls in Older Women

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Exercise Reduced Rate of Injurious Falls in Older Women
Exercise Reduced Rate of Injurious Falls in Older Women

(HealthDay News) — For older women, exercise is associated with reductions in the rate of injurious falls and injured fallers, according to a study published in JAMA Internal Medicine.

Kirsti Uusi-Rasi, PhD, from the UKK Institute for Health Promotion Research in Tampere, Finland, and colleagues examined the effectiveness of targeted exercise training and vitamin D supplementation in reducing falls among older women. 

Participants included 409 home-dwelling women, aged 70 to 80 years, who were randomly assigned to four study groups: placebo without exercise, vitamin D without exercise, placebo and exercise, and vitamin D and exercise.

The researchers observed no reduction in falls with either exercise or vitamin D in intent-to-treat analysis. Per 100 person-years, fall rates were 118.2 for placebo without exercise, 132.1 for vitamin D without exercise, 120.7 for placebo with exercise and 113.1 for vitamin D with exercise; injurious fall rates were 13.2, 12.9, 6.5 and 5.0, respectively. 

Exercisers with and without vitamin D had significantly lower hazard ratios for injured fallers (0.38 and 0.47, respectively). Exercise improved muscle strength and balance, while vitamin D had no positive impact on physical functioning.

"The rate of injurious falls and injured fallers more than halved with strength and balance training in home-dwelling older women, while neither exercise nor vitamin D affected the rate of falls," the researchers wrote.

In a related commentary, Erin S. LeBlanc, MD, MPH, of Kaiser Permanente Northwest, and Roger Chou, MD, of Oregon Health & Science University, both in Portland, Oregon, discussed the study's findings in light of current evidence and guidelines on vitamin D supplementation.

"This trial reminds us that although vitamin D is known as the sunshine vitamin and higher levels are associated with better health in observational studies, more research is needed to understand the effectiveness of vitamin D supplementation on clinical outcomes. In particular, this trial (like many before it) was performed among white European women and may not apply to the diverse U.S. population,” they wrote.

“How should physicians fit this trial into the current USPSTF [U.S. Preventive Services Task Force] recommendation that those at risk of falling should take vitamins D? Given its low cost and low risk, vitamin D should remain in the physician's armamentarium for fall prevention, at least until more data are available." 

Drs. LeBlanc and Chou continued: "Taking a person's vitamin D status into account may be a useful clinical consideration. As more high-quality RCTs [randomized clinical trials] release their findings, we need to be ready to reevaluate the role that vitamin D has in maintaining health. However, the RCT by Uusi-Rasi and colleagues reminds us that the strongest and most consistent evidence for prevention of serious falls is exercise, which has multiple other health benefits."

References

  1. Uusi-Rasi K et al. JAMA Intern Med. 2015;doi:10.1001/jamainternmed.2015.0225.
  2. LeBlanc ES, Chou R. JAMA Intern Med. 2015;doi:10.1001/jamainternmed.2015.0248.
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