Generation Iron: Reducing falls with progressive resistance training and novel digital technology in the oldest old

Generation Iron:The main aim of this project is to reduce falls, fall-related injuries and improve health and quality of life in older adults aged 80+ years.The Norwegian population 80 years or older is estimated to double within the next years. In 2019, 85% of all injuries for adults aged 80 years or older in Norway were caused by falls, and more than half of all adults aged 80 years or older have at least one fall each year. In fact, between 1990 and 2017 Norway had the highest incident rate of falls and the second-highest mortality rate caused by falls for adults aged 70 years or older among 22 European countries. With a previous fall constituting a major risk for a future fall, interventions focusing on preventing falls will provide the best return on investment. Sarcopenia, which is the condition of age-attenuated declines in muscle strength, muscle mass, and physical function, theoretically poses a fall risk in older adults since both high muscle strength capacity in the upper and lower extremities are negatively associated with fall incidence. Exercise programs, including multiple exercise components, especially balance and functional training exercises, appear to most effectively prevent and reduce falls. Although resistance training is proposed as one possible component of a successful multiple-component fall prevention exercise program, the effects of resistance training alone have been deemed either "ineffective" or "uncertain". However, few studies have used resistance training as a stand-alone exercise component. Furthermore, resistance training offers many advantages to balance training, especially for individuals with low muscle strength and muscle mass. By undertaking both a prospective cohort study and a randomised, controlled trial (RCT) we will therefore examine how muscle strength affects falls and fall-related injuries and if regularly undertaken resistance training can prevent falls in the oldest old adults (>80 years). We are, therefore, currently undertaking one of the largest resistance training trials ever for older adults. PROJECT ACHIEVEMENTS IN 2024 We began inviting participants in January 2023 and have now included >210 participants. Final participants expect to be included before August 2024. For the prospective cohort study, we have had significant delays. First, this was due to the slower-than-anticipated delivery of data from a health registry. Second, we saw a need to add a registry (Norwegian Cause of Death Registry) to increase the impact of the paper. We also published a paper providing reference values for body composition in the Norwegian population. The paper was not originally included in the project but is essential for future diagnosis and treatment of sarcopenia and thus highly relevant for the project. Since we previously increased the intervention period of our RCT from 6 to 12 months, and went from 3 months of supervised training to 12, we have seen significant delays also in the RCT. However, the RCT is well underway with much lower than anticipated drop-out rates. We anticipated a 25% drop-out rate and <12% have dropped out so far. We expect the drop-out rate to finish at around 15%. Furthermore, 3 MSc theses were completed using data from the project and we have 4 more MSc students undertaking projects at the moment. We believe this will lead to at least 1 additional scientific paper for the project. Berg also received a travel grant to present findings from the prospective cohort study at The 27th Nordic Congress of Gerontology in Stockholm, Sweden. Although delayed the project will finish and complete its aims and objectives.