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Interventions for preventing falls in older people living in the community
Cochrane update (2012) of 159 trials (79,193 participants): pooled multiple-component group exercise reduced fall rate (rate ratio 0.71, 95% CI 0.63–0.82; 16 trials) and risk of falling (RR 0.85, 95% CI 0.76–0.96; 22 trials); Tai Chi significantly reduced risk of falling (RR 0.71, 95% CI 0.57–0.87; 6 trials) with a rate ratio for falls of 0.72 (95% CI 0.52–1.00; 5 trials) bordering statistical significance.
Design
- Cochrane systematic review update (Sept 2012)
- Included: 159 RCTs, 79,193 community-dwelling older participants
- Common interventions: exercise alone (59 trials), multifactorial programmes (40 trials)
Exercise / Tai Chi signals (abstract-pooled highlights)
- Multiple-component group exercise: fall rate ratio 0.71 (95% CI 0.63–0.82; 16 trials; 3622 participants); risk of falling RR 0.85 (95% CI 0.76–0.96; 22 trials; 5333 participants)
- Tai Chi: risk of falling RR 0.71 (95% CI 0.57–0.87; 6 trials; 1625 participants); fall rate ratio 0.72 (95% CI 0.52–1.00; 5 trials; 1563 participants) — rate ratio CI touches 1.0
Evidence hygiene
- Pooled umbrella across many exercise formats—do not equate Tai Chi pooled RR with any single resistance-training prescription; read subgroup tables and risk-of-bias judgments in the review.
Publication
Gillespie LD, Robertson MC, Gillespie WJ, et al. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007146. PMID 22972103.
Outcomes
- Multiple-component group exercise vs control: fall rate ratio 0.71 (95% CI 0.63–0.82; 16 trials, n=3622); risk of falling RR 0.85 (95% CI 0.76–0.96; 22 trials, n=5333).
- Tai Chi vs control: risk of falling RR 0.71 (95% CI 0.57–0.87; 6 trials, n=1625); fall rate ratio 0.72 (95% CI 0.52–1.00; 5 trials, n=1563).