Multicomponent Exercise for Preventing Falls and Fall-Related Injuries in Community-Dwelling Older Adults: A Systematic Review and Multilevel Meta-Analysis
In brief
Multicomponent exercise cuts falls by 20% in community-dwelling older adults
In a review of 38 studies with 20,183 participants, multicomponent exercise reduced fall incidence by 20% and serious injurious falls by about 26%. Evidence for fewer falls was rated low certainty, and fracture outcomes showed no clear benefit. Results varied substantially between cohorts, so how programs are delivered and falls are measured matters when applying the findings.
- Journal
- Journal of the American Medical Directors Association (Q1)
- Published
- 22 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Yikun Yang, Yugui Hua, Xinyan Li, Haohao Xu, Zixin Gong, Enjing Li, et al.
- PMID
- 42987449
- DOI
- 10.1016/j.jamda.2026.106517
Why clinicians should know about it
- Picked for Public Health, Environmental and Occupational Health (top studies of the week, 8 November 2026): Evidence synthesis evaluates community fall-prevention exercise programmes
Abstract
OBJECTIVES: To quantify the effects of multicomponent exercise on falls and fall-related injuries in community-dwelling older adults and to examine whether intervention, participant, and methodological characteristics explain heterogeneity in treatment effects. DESIGN: Systematic review and multilevel meta-analysis of randomized controlled trials evaluating multicomponent exercise interventions. SETTING AND PARTICIPANTS: Community-dwelling populations with a mean participant age >65 years. METHODS: PubMed, Web of Science Core Collection, Embase, the Cochrane Library, and CINAHL were searched from inception to July 4, 2025, with an updated search on October 20, 2025. Intervention components and delivery characteristics were coded using a standard fall-prevention taxonomy. Three-level random-effects models were used to account for dependent effect sizes from multiarm and multioutcome cohorts. Risk of bias was assessed using Risk of Bias 2, and certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. RESULTS: Thirty-eight studies representing 33 cohorts and 20,183 participants were included. Multicomponent exercise reduced fall incidence (incidence rate ratio [IRR], 0.80; 95% CI, 0.71-0.90), the risk of experiencing at least 1 fall (risk ratio, 0.88; 95% CI, 0.82-0.93), and injurious-fall incidence (IRR, 0.739; 95% CI, 0.627-0.871). Serious injurious falls showed the most consistent reduction (IRR, 0.741; 95% CI, 0.616-0.890), whereas fracture outcomes showed no clear benefit. Heterogeneity in fall incidence was substantial and predominantly between cohorts. Certainty of evidence was low for fall incidence and faller risk but moderate for serious injurious-fall incidence. CONCLUSIONS AND IMPLICATIONS: Multicomponent exercise reduces falls and fall-related injuries in community-dwelling older adults, with the most consistent evidence for serious injurious falls, whereas fracture effects remain uncertain. Substantial between-cohort heterogeneity indicates that differences in implementation, exposure, and outcome ascertainment should be considered when translating pooled effects into practice.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.