Effects of physical and cognitive training on falls and concern about falling in older adults: results from a randomized controlled trial

Authors: TURUNEN, KATRI - University Of Jyvaskyla; TIRKKONEN, ANNA - University Of Jyvaskyla; SAVIKANGAS, TIINA - University Of Jyvaskyla; HANNINEN, TUOMO - Kuopio University Hospital; ALEN, MARKKU - Oulu University Hospital; FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; KIVIPELTO, MIIA - Finnish Institute For Health And Welfare; NEELY, ANNA - Karlstad University; TORMAKANGAS, TIMO - University Of Jyvaskyla; SIPILA, SARIANNA - University Of Jyvaskyla

Submitted to: Journals of Gerontology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/7/2021
Publication Date: 12/15/2021
Citation: Turunen, K.M., Tirkkonen, A., Savikangas, T., Hanninen, T., Alen, M., Fielding, R., Kivipelto, M., Neely, A.S., Tormakangas, T., Sipila, S. 2021. Effects of physical and cognitive training on falls and concern about falling in older adults: results from a randomized controlled trial. Journals of Gerontology. 77(7):1430-1437. https://doi.org/10.1093/gerona/glab375.
DOI: https://doi.org/10.1093/gerona/glab375

Interpretive Summary: This study investigated whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Community-dwelling men and women aged 70-85 years were randomly assigned (by the flip of a coin) into combined physical and cognitive training (PTCT) or PT for one year. PT included supervised and home-based physical exercises following national physical activity recommendations. PTCT included PT and computer-based cognitive training. There was no significant difference in the rate of falls during the intervention between the PTCT and PT groups. A yearlong PTCT intervention did not result in a significantly lower rate of falls than PT alone in older community-dwelling adults.

Technical Abstract: Background: The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Methods: This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70-85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cognitive training. The outcome was the rate of falls over the 12-month intervention (PTCT, n = 151 and PT, n = 155) and 12-month postintervention follow-up (PTCT, n = 143 and PT, n = 148). Falls were ascertained from monthly diaries. Exploratory outcomes included the rate of injurious falls, faller/recurrent faller/fall-related fracture status, and concern about falling. Results: Estimated incidence rates of falls per person-year were 0.8 (95% confidence interval [CI] 0.7-1.1) in the PTCT and 1.1 (95% CI 0.9-1.3) in the PT during the intervention and 0.8 (95% CI 0.7-1.0) versus 1.0 (95% CI 0.8-1.1), respectively, during the postintervention follow-up. There was no significant difference in the rate of falls during the intervention (incidence rate ratio [IRR] = 0.78; 95% CI 0.56-1.10, p = .152) or in the follow-up (IRR = 0.83; 95% CI 0.59-1.15, p = .263). No significant between-group differences were observed in any exploratory outcomes. Conclusion: A yearlong PTCT intervention did not result in a significantly lower rate of falls or concern about falling than PT alone in older community-dwelling adults.