Citation

Kemmler W, von Stengel S, Engelke K, Häberle L, Kalender WA. Arch. Intern. Med. 2010; 170(2): 179-185.

Affiliation

Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nuremberg, Henkestrasse 91, 91052 Erlangen, Germany. wolfgang.kemmler@imp.uni-erlangen.de

Copyright

(Copyright © 2010, American Medical Association)

DOI

10.1001/archinternmed.2009.499

PMID

20101013

Abstract

BACKGROUND: Physical exercise affects many risk factors and diseases and therefore can play a vital role in general disease prevention and treatment of elderly individuals and may reduce costs. We sought to determine whether a single exercise program affects fracture risk (bone mineral density BMD. and falls), coronary heart disease (CHD) risk factors, and health care costs in community-dwelling elderly women. METHODS: We conducted a randomized, single-blinded, controlled trial from May 1, 2005, through July 31, 2008, recruiting women 65 years or older who were living independently in the area of Erlangen-Nuremberg, Germany. In all, 246 women were randomly assigned to an 18-month exercise program (exercise group) or a wellness program (control group). The exercise group (n = 123) performed a multipurpose exercise program with special emphasis on exercise intensity; the controls (n = 123) focused on well-being with a low-intensity, low-frequency program. The main outcome measures were BMD, the number of falls, the Framingham-based 10-year CHD risk, and direct health care costs. RESULTS: For the 227 women who completed the 18-month study, significant exercise effects were observed for BMD of the lumbar spine (mean 95% confidence interval (CI). percentage of change in BMD baseline to follow-up. for the exercise group: 1.77% 1.26% to 2.28%. vs controls: 0.33% -0.24% to 0.91%.; P < .001), femoral neck (exercise group: 1.01% 0.37% to 1.65%. vs controls: -1.05% -1.70% to -0.40%.; P < .001), and fall rate per person during 18 months (exercise group: 1.00 0.76 to 1.24. vs controls: 1.66 1.33 to 1.99.; P = .002). The 10-year CHD risk was significantly affected in both subgroups (absolute change for the exercise group: -1.96% 95% CI, -2.69% to -1.23%. vs controls: -1.15% -1.69% to -0.62%.; P = .22), with no significant difference between the groups. The direct health care costs per participant during the 18-month intervention showed nonsignificant differences between the groups (exercise group: 2255 euros95% CI, 1791 euros-2718 euros. vs controls: 2780 euros 2187 euros-3372 euros.; P = .20). CONCLUSION: Compared with a general wellness program, our 18-month exercise program significantly improved BMD and fall risk, but not predicted CHD risk, in elderly women. This benefit occurred at no increase in direct costs.

Language: en