Exercise Arises as a Key Strategy to Reduce Falls in Polypharmacy for Elderly Women
Steven Shin
March 2025
Among the elderly, a condition known as polypharmacy became one of the most significant public health concerns. Recent research by the University of Eastern Finland and Kuopio University Hospital has highlighted the effectiveness of structured exercise in reducing fall risks in elderly women.[3] The study underscores the importance of incorporating physical activity into healthcare strategies aimed at fall prevention.
The Impact of Polypharmacy on Physical Function
Polypharmacy, the concurrent use of four or more medications, has been linked to deteriorating physical fitness and an increased risk of falls.[3] As older adults frequently require multiple medications to manage chronic conditions, this association is concerning. However, while previous studies have suggested a direct correlation between polypharmacy and higher fall risks, the recent findings challenge this notion by demonstrating that targeted exercise programs can mitigate these risks.[2]
The Kuopio Fall Prevention Study: A Game-Changer
The study analyzed data from the Kuopio Fall Prevention Study, a randomized controlled trial involving 914 women with a median age of 76.5 years. Participants were randomly assigned to either an exercise group or a control group. The exercise program consisted of twice-weekly guided exercise sessions, including tai chi and circuit training, for the first six months. Afterward, participants were granted free access to the city’s recreational sports facilities for an additional six months.[3] Fitness assessments were conducted at baseline, one year, and two years into the study. Medication use was tracked through self-reported questionnaires, and falls were monitored for approximately two years via biweekly SMS queries.[3]
The results of the study were compelling. Among participants with polypharmacy, those engaged in the exercise intervention exhibited a 29% lower risk of falls compared to the control group taking zero to one medications.[1] Additionally, while 1,380 falls were recorded during the study period—739 of which resulted in injury or pain and 63 in fractures—polypharmacy did not increase the likelihood of falls in the control group.[3] Moreover, fitness tests revealed that participants using zero to one medications generally performed better than those with polypharmacy. However, individuals with the poorest physical fitness at the outset of the study
benefited the most from the intervention.[2] This finding suggests that physical activity can significantly enhance functional ability, even among those with limited mobility.
Patient Outcomes and Future Directions
The study’s findings reinforce the need to integrate structured exercise programs into standard geriatric care. Healthcare professionals should actively encourage physical activity, particularly for elderly patients managing multiple medications. The benefits of tai chi and circuit training extend beyond fall prevention; they contribute to improved balance, strength, and overall quality of life.[4]
Additionally, previous research has linked polypharmacy to reduced physical function, further emphasizing the importance of targeted exercise interventions. For example, a systematic review found a reciprocal relationship between polypharmacy and diminished physical performance in older adults. Similarly, findings from the Medical Research Council National Survey of Health and Development indicated that polypharmacy at ages 60 to 69 was associated with poorer cognitive and physical capabilities, even when accounting for chronic disease burden.[1]
Given the significant benefits demonstrated by the Kuopio Fall Prevention Study, exercise should be a cornerstone of fall prevention strategies for elderly individuals, particularly those with polypharmacy. Encouraging participation in structured physical activity programs may not only reduce fall risk but also enhance overall physical well-being. Future research should continue exploring how tailored interventions can further optimize outcomes for older adults managing multiple medications.
References
[1] Corbett, A., Stevens, T., Aarsland, D., Day, S., & Ballard, C. (2018). Systematic review of polypharmacy and cognitive impairment in older adults. Journal of the American Geriatrics Society, 66(6), 1071-1080. https://doi.org/10.1111/jgs.15374
[2] Gutiérrez-Valencia, M., Aldaz-Herce, P., Lacalle-Fabo, E., Larrayoz-Sola, B., Martínez-Velilla, N., & Fernández de Retana-Marín, A. (2018). Relationship between polypharmacy and functional capacity in older adults: A systematic review. Aging & Disease, 9(6), 1014-1022. https://doi.org/10.14336/AD.2018.0611
[3] Vilpunaho, T., Kröger, H., Honkanen, R., Koivumaa-Honkanen, H., Sirola, J., Kuvaja-Köllner, V., … & Rikkonen, T. (2019). Randomised controlled trial (RCT) study design for a large-scale municipal fall prevention exercise programme in community-living older
women: study protocol for the Kuopio Fall Prevention Study (KFPS). BMJ open, 9(6), e028716. https://doi.org/10.1136/bmjopen-2018-028716 [4] Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., & Clemson, L. (2017). Exercise for preventing falls in older people living in the community: An abridged Cochrane systematic review. British Journal of Sports Medicine, 51(24), 1750-1758. https://doi.org/10.1136/bjsports-2017-098425
