JULY 2009

Nearly a third of people over age 65 suffer a fall every year, with 20% of those spills requiring medical attention. Exercises that target balance and strength, such as Tai Chi, can reduce your risk of a possibly crippling fall, according to a new review of 111 trials totaling 55,303 participants.

Lesley D. Gillespie, from Dunedin Medi cal School in New Zealand, and colleagues found that exercise programs, studied in 43 of the trials, were effective at reducing both the rate of falls and the risks of falling. Reduct ions in fall risk ranged from 17% for multi-component group programs (such as drug management,home-fall prevention and eyeglasses assistance) to 35% for Tai Chi. Five studies of fracture risk also found that exercise reduced the likelihood of people breaking bones by a combined 64%.

Exercise regimens, Gillespie and colleagues noted, can target four separate physical attributes: strength, endurance, flexibility and balance. The exercise programs most effective against falls were those aimed at improving strength and balance.

Writing in the Cochrane Reviews medical database, the reviewers concluded, “The effect of exercise programs in reducing the risk and rate of falling should now be regarded as established.”

Other fall-prevention efforts—including drug-dose adjustments and home-safety assessments—lacked convincing evidence of benefit, the reviewers found. One intervention, however—a traction device attached to shoes in icy conditions—did stand out as effective, reducing falls by 58%. And people at high risk for falls, such as those with impaired vision, may benefit from home-safety interventions.

“Taking vitamin D supplements probably does not reduce falls,” Gillespie and colleagues added, “except in people who have a low level of vitamin D in the blood.” (Recent research, however, suggests that as many as three-quarters of Americans may suffer such vitamin D deficiency; see our June 2009 Special Report.)

TO LEARN MORE:Cochrane Database of Systematic Reviews,dx.doi.org/10.1002/14651858.CD007146.pub2. Tufts’ John Hancock Center on Physical Activity and Nutritionjhcpan.nutrition.tufts.edu