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Exercise, Processing Speed, and Subsequent Falls: A Secondary Analysis of a 12-Month Randomized Controlled Trial.

Teresa Liu-Ambrose1,2, Jennifer C Davis2,3, Ryan S Falck1,2

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Summary

The Otago Exercise Program reduced moderate injurious falls in older adults. Improved processing speed, measured by the Digit Symbol Substitution Test (DSST), was a key factor in this reduction.

Keywords:
Cognitive functionExercise trainingFall preventionMediation analysis

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Area of Science:

  • Gerontology
  • Exercise Science
  • Cognitive Neuroscience

Background:

  • Falls are a significant concern for community-dwelling older adults.
  • Exercise programs, like the Otago Exercise Program, are known to reduce fall rates.
  • Cognitive function, particularly processing speed, is also linked to fall risk.

Purpose of the Study:

  • To investigate if improved processing speed mediates the effect of the Otago Exercise Program on fall rates.
  • To examine the impact on total, non-injurious, moderate injurious, and serious injurious falls.

Main Methods:

  • A secondary analysis of a 12-month randomized clinical trial involving 256 older adults (≥70 years) who had previously fallen.
  • Participants received either usual care or usual care plus the Otago Exercise Program.
  • Processing speed was assessed using the Digit Symbol Substitution Test (DSST) at baseline and 12 months; causal mediation analyses were performed.

Main Results:

  • The Otago Exercise Program significantly reduced moderate injurious falls (IRR = 0.49).
  • Participants in the exercise group showed improved processing speed (mean difference = 1.16 points).
  • Enhanced DSST scores mediated the exercise's effect on reducing moderate injurious falls (p = .036).

Conclusions:

  • Improved processing speed is a potential mechanism through which exercise reduces moderate injurious falls in older adults.
  • The findings highlight the dual benefits of exercise for physical and cognitive health in fall prevention.