Effectiveness of statewide falls prevention efforts with and without group exercise

Group-based falls prevention programs vary in use of exercise, education, home modification, and other program elements. Pennsylvania's Department of Aging offers two large-scale falls prevention programs that differ in these components, allowing a strong test of the effectiveness of exercise in reducing falls incidence relative to less intensive education-based programs. In 2016-2017, we followed three groups of older adults attending senior centers: (i) older adults who completed Healthy Steps in Motion (HSIM, n = 560), an 8-week exercise program, (ii) older adults completing Healthy Steps for Older Adults (HSOA, n = 651), a falls education workshop with assessment and referral; and (iii) older adults not completing falls prevention programs (n = 787). Participants were followed for up to 6 months with monthly ascertainment of falls. We estimated Poisson regression models to compare incidence rate ratios. The groups did not differ in falls risk at baseline or attrition over follow-up. HSIM participants reported 5.3 fall months per 100 person-months of follow-up. The group not completing falls prevention programming reported 7.3 (incidence rate ratio [IRR], 0.72 [0.59, 0.89]), and the group completing HSOA 6.5 (IRR, 0.82 [0.66, 1.02]). In stratified analyses, falls incidence was lower in HSIM for older adults reporting better balance and no falls in the prior 12 months. Non-exercise-based falls prevention programs may also reduce falls, perhaps through indirect physical benefits such as greater social engagement and increased activity.