Exercise, vitamin D prevented falls in elderly

Exercise or physical therapy and vitamin D supplementation could prevent falls in community-dwelling adults aged at least 65 years who are at risk for falls, according to the United States Preventive Services Task Force’s new recommendation guidelines.

In 1996, the US Preventive Services Task Force (USPSTF) examined the effectiveness of counseling to prevent household and recreational injuries, such as falls, by age group. Since then, the USPSTF updated its methods, reviews and rating system to evaluate findings.

“Falls are the leading cause of injury in adults aged 65 years or older. Between 30% and 40% of community-dwelling adults aged 65 years or older fall at least once per year,” the report said.

Virginia A. Moyer, MD, MPH, of the USPSTF, and colleagues wrote that they found “convincing evidence that exercise or physical therapy has moderate benefit in preventing falls in older adults.”

The USPSTF examined several studies, with an emphasis on outcomes such as falls, fractures, quality of life and mortality. Moreover, risk assessments conducted by primary care physicians are recommended in older adults at increased risk for falls, they said. Those with a history of falls, history of mobility problems and poor performance on a timed Get-Up-and-Go test (the time it takes a patient to rise from an armchair, walk 3 m, turn, walk back and sit down again) are to be identified before interventions.

Interventions include exercise or physical therapy and vitamin D supplementation. The USPSTF also recommended screenings for osteoporosis as early intervention. Within the report, the CDC and National Institute on Aging recommend similar interventions.

The USPSTF said further studies are needed to validate the substantial risk for falls in older adults. Other trials should examine interventions that evaluate visual correction, medication withdrawal, protein supplementation, education/counseling and home hazard modification as it relates to risk for falls.

Disclosure: Dr. Moyer received travel support to meetings for the study from AHRQ/USPSTF and consultancy fees from AAP. Disclosure forms for all other USPSTF members can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-0471.

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