A retrospective cohort study examined a demographically representative
sample from a Washington State integrated health system.
Health plan members aged 65 or older, including 2,095 Enhance-
Fitness users, 13,576 Silver Sneakers users, and 55,127 nonusers
from 2005 through 2011, were classified as consistent users (used
a program ≥2 times in all years they were enrolled in the health
plan during the study period); intermittent users (used a program
≥2 times in 1 or more years enrolled but not all years), or nonusers
of EnhanceFitness or Silver Sneakers. The main outcome
was measured as time-to-first-fall requiring inpatient or out-ofhospital
medical treatment based on the International Classification
of Diseases, 9th Revision, Clinical Modification, Sixth Edition
and E-codes.