Rolling a tennis ball underfoot is one of the exercises designed to help seniors get a sense of bumps on the ground. (CBC)

Exercise programs may help prevent falls among elderly people living at home, a review suggests.

About a third of people over 65 who aren't living in seniors homes fall each year, researchers say. Less than 10 per cent of falls result in fractures but fractures from falls are a major cause of death and disability among older people.

It's thought that exercise such as group tai chi sessions or individual workouts at home may help.

"What remains less clear is whether some other interventions really do reduce falls," said lead researcher Lesley Gillespie, of Dunedin School of Medicine at the University of Otago in New Zealand.

Previous studies pointed to differences depending on whether seniors were in hospital or in nursing homes, Gillespie said.

In Wednesday's Cochrane Database of Systematic Reviews Gillespie's team evaluated data from 111 trials, including more than 55,000 people over 60. The Cochrane Collaboration evaluates medical research.

The trials looked at:

• Individual home-based exercises.
• Vitamin D supplements to reduce muscle weakness.
• Home safety improvements.
• Cataract surgery.

People who took part in exercise programs were less likely to suffer a fall, the reviewers concluded.

Exercise programs may aim to improve strength, flexibility, balance and endurance.

"Programmes that contain two or more of these components reduce rate of falls and number of people falling," the reviewers concluded.

"Exercising in supervised groups, participating in tai chi, and carrying out individually prescribed exercise programmes at home are all effective."

There was also some evidence from single trials supporting other interventions.

"When a medical cause could be identified [like heart or vision issues], interventions to repair these did reduce falls," said study co-author Dr. Brian Rowe, a research director in the department of emergency medicine at the University of Alberta.

"For people with cataracts, there was a significant reduction in rate of falls in people receiving expedited cataract surgery for the first eye. So this suggests that expedited care could save patients from harm," he added in an email.

Gradually tapering off some drugs such as sleeping pills or medications to reduce anxiety and wearing anti-slip shoes in icy conditions also seemed to help prevent falls.

But taking vitamin D supplements to reduce the risk of falls only appeared to help those with vitamin D deficiencies.

Adding home safety changes were also relatively unsuccessful, except in high-risk groups, such as people who are visually impaired, the reviewers said.