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A study in the British Medical Journal found that exercise is superior to home hazard modifications and vision correction when it comes to reducing the number of at-home falls among the elderly.

Researchers at the Accident Research Center in Victoria, Australia, conducted the study among 442 people 70 years and older and living in their own home or apartment. The subjects were randomly assigned to receive at least one of three interventions: a weekly hour-long exercise class, supplemented with daily home exercises; home hazards modification done by the participants or the city's home maintenance program; or vision improvement treatment.

Some subjects received two interventions, one group received all three, and a control group had no interventions. In all, eight groups were studied over an 18-month period. All participants submitted a monthly postcard, on which they recorded their falls.

Exercise was the most effective

The study found that among individual interventions, exercise had the greatest impact on reducing falls. Patients who had their homes modified or their vision corrected had a minimal reduction in their annual fall rate of 3.1% and 4.4%, respectively, compared with the exercise group, which had a significant 6.9% reduction. The group who had all three interventions fared the best, with an estimated reduction in annual falls of 14%.

Exercise improves balance

Patients who took the exercise class were able to reduce their rate of falling primarily by improving their balance, the authors said. The other two interventions may have been less effective because they were not as intense as they needed to be.

The findings lend further support to the importance of exercise in helping elderly people maintain physical function. A study in the American Journal of Preventive Medicine reported that inactive elderly adults showed improvement in physical function after taking an hour-long tai chi class twice a week for 6 months. The improvement was most pronounced among the previously least active participants.

According to the authors of the British Medical Journal study, this research together suggests that exercise programs involving balance improvement might benefit elderly people. More research on the cost effectiveness of such programs is needed to determine whether such programs are worthwhile in helping to prevent falls among the elderly.


Day L, Fildes B, Gordon I, et al. Randomised factorial trial of falls prevention among older people living in their own homes. BMJ. 2002;325:128-133.

Li F, Fisher KJ, Harmer P, McAuley E. Delineating the impact of Tai Chi training on physical function among the elderly. Am J Prev Med. 2002;23(2S):92-97.

Review Date: 6/28/2011

Reviewed By: Jeffrey Heit, MD, Internist with special emphasis on preventive health, fitness and nutrition, Philadelphia VA Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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