Session number: 1122
Abstract title: Low Intensity Exercise and Falls Risk Among a Clinically Defined Sample of At-Risk Elders
Author(s):
RO Morgan - Houston Center for Quality of Care and Utilization Studies
M Duque - Miami VA Medical Center
CA DeVito - Miami VA Medical Center
Objectives: Falls are the leading cause of nonfatal injuries in the U.S. and the second leading cause of all unintentional injury deaths. Elderly individuals appear to be at especially high risk for falls during the period immediately following a hospitalization, potentially due to deconditioning resulting from their hospital stay. The impact of community-based exercise programs on falls risk reduction appears equivocal, and varies widely across studies reported in the literature. This study examined the impact of a community-based, short-term, low-intensity exercise intervention on time-to-first fall among a clinically defined population of elderly men and women.
Methods: Two hundred twenty-nine men and women subjects, aged 60 years or older, who had been hospitalized or on bed rest for 2+ days within the prior month, were randomized into either an intervention or control group. Subjects completing the intervention received 24 sessions of an individualized low-intensity program of standard exercise modalities across an eight to ten week period. Measures of physical function and performance were collected for all subjects at baseline. Falls were tracked for up to one year.
Results: Analyses controlled for age, sex, falls history over the prior 12 months, and baseline measures of gait and balance. Using a median split, subjects were dichotomized into high and low physical function (PF) groups based on their baseline SF-36 PF subscale score. Intervention group assignment interacted significantly with baseline PF status (p < .01). Subjects who were initially at low PF levels showed a significant intervention-related reduction in falls risk (p < .04; hazard ratio [HR] = .53), while those at high initial PF levels showed a marginally significant increase in risk (p < .07; HR = 2.42).
Conclusions: This easily implemented, low-intensity exercise program can lead to improvements in falls risk among elderly men and women recovering from recent hospitalizations and/or bed rest. However, the impact on falls risk appears to depend on the physical function level of the participants at baseline.
Impact statement: Our results help to clarify findings reported from prior studies, and suggest that low intensity exercise for the purpose of falls reduction may be best targeted at specific subgroups of elderly.