Reducing falls among older people in general practice: The ProAct65+ exercise intervention trial

Area of Science:

• Gerontology
• Public Health
• Exercise Science

Background:

• Falls are a significant issue for older adults in the UK, leading to high healthcare costs.
• Home and group-based exercise programs can reduce falls by up to 42% in high-risk individuals.
• Evidence for fall reduction in low-risk older adults is less clear.

Purpose of the Study:

• To investigate the effectiveness of the Otago Exercise Programme (OEP) and Falls Management Exercise (FaME) interventions on reducing falls and falls-related injuries.
• To compare the effectiveness of OEP and FaME against usual care in community-dwelling older adults.
• To examine secondary outcomes of moderate to vigorous physical activity (MVPA) in older adults.

Main Methods:

• A large, cluster-randomised controlled trial (ProAct65+) involving 1256 community-dwelling older adults (aged 65+).
• Participants were randomised to OEP, FaME, or usual care (UC).
• Falls data were collected via diaries and follow-up recall over 24 months; balance and confidence were also assessed.

Main Results:

• The FaME group showed a significant reduction in injurious falls (IRR 0.55) and all falls (IRR 0.74) compared to UC in the 12 months post-intervention.
• These benefits ceased at 24 months, except in FaME participants who maintained higher MVPA levels (IRR 0.49).
• Balance confidence improved in both intervention groups, but functional balance measures did not significantly change.

Conclusions:

• The FaME intervention effectively reduced falls and injurious falls in older adults for up to 12 months post-intervention.
• Sustained physical activity is crucial for long-term fall reduction benefits.
• The OEP intervention showed less effectiveness in this functionally able older adult population.