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

GENERATION IRONThe 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 programmes, 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 programme, 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. We began inviting participants in January 2023 and currently have 120 included participants. For the RCT, we have a close collaboration with 3T Treningssenter AS. 3T provide the training venue for the participants in the treatment arm and contributes with their personnel for the supervision of participants. We are currently undertaking the final analyses for the prospective cohort study and expect to publish a scientific paper on the results in 2024. Our preliminary findings demonstrate the importance of muscle strength and muscle mass in preventing falls and fall injuries in older adults aged 80+ years. In addition, we have one paper related to the project in review, which will provide comprehensive reference material for body composition among healthy men and women from 20 to 99 years of age. Finally, in 2023, the project leader attained funding for a PhD candidate who will focus on the importance of muscular strength and resistance training for cardiovascular health in older adults.