Adherence and effectiveness of multicomponent exercise fall prevention programmes across delivery formats in community-dwelling older adults: a systematic review and multilevel meta-analysis.

Yugui Hua; Yikun Yang; Yaxuan Chen; Haiqiu Long; Enjing Li

doi:10.1016/j.archger.2026.106304

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Adherence and effectiveness of multicomponent exercise fall prevention programmes across delivery formats in community-dwelling older adults: a systematic review and multilevel meta-analysis.

Yugui Hua·Yikun Yang·Yaxuan Chen·Haiqiu Long·Enjing Li

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Abstract

BACKGROUND: Multicomponent exercise is widely implemented for fall prevention in older adults, but the role of exercise adherence and delivery format in determining intervention effectiveness remains inadequately understood, particularly in analyses that account for within-study outcome dependence. METHODS: We searched five databases to 23 November 2025 for RCTs of multicomponent exercise in adults aged ≥60 years. Fall outcomes were synthesised using three-level random-effects meta-analysis and meta-regression, with adherence evaluated as continuous/categorical factors and as moderator alongside delivery format, accounting for within-study effect-size dependence. RESULTS: Forty-one publications were included, comprising 36 distinct cohorts and involving 20,202 participants. Multicomponent exercise programmes significantly reduced fall incidence (IRR = 0.776, 95% CI 0.641-0.939), risk of experiencing at least one fall (RR = 0.914, 95% CI 0.858-0.974), and fall-related injury incidence (IRR = 0.754, 95% CI 0.663-0.858). Programmes achieving adherence ≥75% were independently associated with greater reductions in fall incidence (IRR = 0.501, 95% CI 0.336-0.747) and fall risk (RR = 0.821, 95% CI 0.697-0.967). Mean adherence was highest in combined individual and group delivery, lower in single-format programmes, though including a group component may enhance adherence. CONCLUSIONS: Multicomponent exercise fall prevention programmes are effective for fall prevention in community-dwelling older adults, whereas evidence for their protective effects on fall-related injury outcomes remains limited. Adherence is an important factor influencing programme implementation and intervention effectiveness.

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Aged Aged, 80 and over Humans Middle Aged Accidental Falls Exercise Therapy Independent Living Patient Compliance Randomized Controlled Trials as Topic Adherence Delivery formats Falls Multicomponent exercise Multilevel meta-analysis Older adults Systematic review Journal Article Meta-Analysis Systematic Review

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Yugui Hua, Yikun Yang, Yaxuan Chen, Haiqiu Long, Enjing Li. 2026-05-20. Adherence and effectiveness of multicomponent exercise fall prevention programmes across delivery formats in community-dwelling older adults: a systematic review and multilevel meta-analysis.. https://doi.org/10.1016/j.archger.2026.106304

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Journal Article; Meta-Analysis; Systematic Review resource Adherence subject Aged subject Aged, 80 and over subject Exercise Therapy subject Humans subject Journal Article subject Meta-Analysis subject Middle Aged subject Patient Compliance subject Systematic reviews study older adults subject

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