An exercise program to prevent falls in institutionalized elderly with cognitive deficits: a crossover pilot study

Falls are the leading cause of injury among older adults in the United States, with the institutionalized elderly at elevated risk for injury and death. Physical weakness and mental frailty, prevalent in institutionalized elderly, are major risk factors for falls. The purpose of this study was to evaluate a program that addresses both the physical and mental aspects of exercise to reduce falls in institutionalized elderly. Twenty-seven volunteer subjects residing in an assisted living facility participated in the 24 week randomized crossover study. After demographic, fall history, and mental status examinations, subjects were randomly assigned first to ten weeks of either an exercise class or a control group, followed by a four week "washout period" of no activity, then cross assigned to ten weeks as either a control group or exercise class, respectively. Falls as well as mental status changes were monitored during the study. After adjusting for differences in baseline risk between the control and treatment groups, and for potential residual effects of the treatment during the crossover phase, a statistically significant (P = .025) reduction in falls was found during treatment compared to the control periods. No change in mental status was seen. This small, pilot study shows that exercise programs, which emphasize mental strengthening as well as physical fitness, have the potential to reduce falls among mentally impaired, institutionalized seniors.