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Introduction: This systematic review examines the evidence to prescribe exercise to reduce fear of falling in older people.Method: Nine bibliographic databases were searched for published or current randomised control trials (RCT) and quasi-randomised trials (QRT) from 1887 to August 2013 (Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, The WHO International Clinical Trials Registry Platform, and Current Controlled Trials). Trials were included where fear of falling was recorded as a primary or secondary outcome in community dwelling older people aged 65 years and older, not restricted to a specific medical condition, participants were provided with single component exercise interventions and control group included routine care which did not increase exercise. Reference lists of included studies were searched and experts in the field contacted to suggest relevant unidentified studies.Results: Thirty studies met the inclusion criteria (2,578 participants, mean age 70 to 84 years, 70% women). Structured exercise programmes were associated with a significant reduction in fear of falling immediately post-intervention (SMD 0.24, 95% CI 0.14 to 0.34). There was no significant effect of exercise interventions on fear of falling beyond the end of the intervention period (three studies included data up to six months and two included data at six months and beyond). Structured exercise programmes were associated with a significant reduction in the rate of falls (pooled rate ratio 0.70, 95% CI 0.56 to 0.89); however, there was no significant effect on depressive symptoms (four studies), self-reported physical activity levels (four studies) or adherence rates (16 studies).Conclusions: Exercise is an effective means to reduce fear of falling in older people living in the community whilst the exercise is being prescribed but there is a lack of evidence on the duration of the effect. [ABSTRACT FROM AUTHOR]

Introduction: Sedentary behaviour is bad for health, even in those who achieve the recommended levels of moderately vigorous physical activity. Older people are the most sedentary, and sedentary behaviour is associated with gender, age, income, education, falls, co-morbidities and polypharmacy. We aimed to explore the characteristics of sedentary older people enrolled in a health promotion and exercise trial and compare them with sedentary older people in previous epidemiological studies.Methods: Data collected from participants in the PROACT65+ trial between 2009-2011 were categorised into two groups - sedentary or not. The sedentary group reported sitting for > 4 hours/day on > 5 days per week. Covariates examined were demographic data, health status, self-rated function and physical test performance (including Timed-Up-and-Go, chair stand, falls risk, functional reach). The complete data sets of 918 participants were analysed.Results: The sedentary were more likely to be underweight (BMI <18.5) or overweight (BMI >25) (OR 1.563, CI 1.109–2.203), to have been smokers (OR 1.488, CI 1.064–2.082) and to be limited in their daily activities on more than 5 days/month (OR 2.217, CI 1.047–4.692). Contrary to previous epidemiological studies, participants' sedentary behaviour was not associated with gender, age, income, education, falls, number of co-morbidities or polypharmacy.Conclusion: Community exercise trials can recruit sedentary older people. However, sedentary participants in this large multi-centre structured exercise programme were different from community-dwelling sedentary older people in epidemiological studies. Trial participants are a different, perhaps more motivated cohort, even when habitually sedentary. [ABSTRACT FROM AUTHOR]