BACKGROUND Physical exercise is beneficial to reduce the risk of several conditions associated with advanced age, but to our knowledge, no previous study has examined the association of long-term exercise interventions (≥ 1 year) with the occurrence of dropouts due to health issues and mortality, or the effectiveness of physical exercise versus usual primary care interventions on health-related outcomes in older adults (≥ 65 years old). OBJECTIVE To analyze the safety and effectiveness of long-term exercise interventions in older adults. METHODS We conducted a systematic review with meta-analysis examining the association of long-term exercise interventions (≥ 1 year) with dropouts from the corresponding study due to health issues and mortality (primary endpoint), and the effects of these interventions on health-related outcomes (falls and fall-associated injuries, fractures, physical function, quality of life, and cognition) (secondary endpoints). RESULTS Ninety-three RCTs and six secondary studies met the inclusion criteria and were included in the analyses (n = 28,523 participants, mean age 74.2 years). No differences were found between the exercise and control groups for the risk of dropouts due to health issues (RR = 1.05, 95% CI 0.95-1.17) or mortality (RR = 0.93, 95% CI 0.83-1.04), although a lower mortality risk was observed in the former group when separately analyzing clinical populations (RR = 0.67, 95% CI 0.48-0.95). Exercise significantly reduced the number of falls and fall-associated injuries, and improved physical function and cognition. These results seemed independent of participants' baseline characteristics (age, physical function, and cognitive status) and exercise frequency. CONCLUSIONS Long-term exercise training does not overall influence the risk of dropouts due to health issues or mortality in older adults, and results in a reduced mortality risk in clinical populations. Moreover, exercise reduces the number of falls and fall-associated injuries, and improves physical function and cognition in this population.

中文翻译：

---

老年人长期运动干预的安全性和有效性：随机对照试验的系统评价和荟萃分析。

背景技术体育锻炼有利于降低与高龄有关的多种疾病的风险，但是据我们所知，以前没有研究检查长期运动干预（≥1年）与因健康问题而辍学的相关性。死亡率或体育锻炼与常规初级保健干预措施对老年人（≥65岁）健康相关结局的有效性。目的分析老年人长期运动干预的安全性和有效性。方法我们采用荟萃分析进行了系统的回顾，研究了长期运动干预（≥1年）与由于健康问题和死亡率（主要终点）而从相应研究中途辍学的相关性，以及这些干预措施对健康相关结局（跌倒和跌倒相关的伤害，骨折，身体功能，生活质量和认知）的影响（次要终点）。结果93项RCT和6项次要研究符合纳入标准，并纳入分析（n = 28,523名参与者，平均年龄74.2岁）。运动组和对照组之间因健康问题（RR = 1.05，95％CI 0.95-1.17）或死亡率（RR = 0.93，95％CI 0.83-1.04）导致辍学的风险没有差异，尽管死亡率较低分别分析临床人群时，前一组患病风险较高（RR = 0.67，95％CI 0.48-0.95）。锻炼显着减少了跌倒和跌倒相关伤害的次数，并改善了身体机能和认知能力。这些结果似乎独立于参与者的 基线特征（年龄，身体功能和认知状态）和运动频率。结论长期运动训练并不能整体影响老年人因健康问题或死亡率而辍学的风险，并且可以降低临床人群的死亡风险。此外，运动减少了跌倒和跌倒相关伤害的次数，并改善了该人群的身体机能和认知能力。