Exercise intervention reduces fall risk in elderly women on multiple medications

An exercise intervention aimed at elderly women was successful at reducing falls, especially among those with polypharmacy, a new study from the University of Eastern Finland and Kuopio University Hospital shows. The results were published in Scientific Reports.

The researchers also found that polypharmacy was associated with poorer results in functional tests measuring physical fitness. Polypharmacy was defined as the regular use of four or more medications.

Our findings suggest that, in order to enhance fall prevention in the elderly population, efforts to increase physical activity should be targeted specifically at those using multiple medications."

Anna-Erika Tamminen, Researcher, Kuopio Musculoskeletal Research Unit, University of Eastern Finland

According to Research Director Toni Rikkonen, the effectiveness of the exercise intervention was, as expected, largely dependent on the initial fitness level: "Those with the poorest physical fitness initially benefitted the most."

The researchers conducted a secondary analysis of the Kuopio Fall Prevention Study data. The randomized controlled trial included 914 women, with the median age being 76.5 years at the onset of the study. Half of the women were randomized into an exercise intervention group and half into a control group. All participants underwent fitness tests at the beginning of the study, and again one and two years later. Medication use was assessed with a baseline questionnaire, and participants were divided into six groups based on the number of medications used. Falls were monitored for about two years through biweekly SMS queries sent to participants.

The exercise intervention included guided exercise sessions twice a week for the first six months, with tai chi on one day and circuit training on the other. For the following six months, participants had free access to the city's recreational sports facilities.

During the follow-up, 1,380 falls were reported, of which 739 resulted in an injury and pain, and 63 in a fracture. The lowest risk of fall was among women with polypharmacy who participated in the exercise intervention. Their risk was 29% lower than that of the control group using zero to one medications and not participating in the intervention.

Previous studies have associated polypharmacy with an increased the risk of fall; however, in this study, polypharmacy did not affect the number of falls in the control group. Furthermore, no association was observed between the number of medications used and the number of fractures. Fitness test results were best among those who used zero to one medications both in the control and intervention groups, and poorest among those using multiple medications throughout the follow-up.