Background Physical exercise has been shown to reduce falls and subsequent injuries. In a low cost, cross-sectoral program “The Strength in Old Age” health exercise interventions for elderly people were implemented in 38 municipalities in Finland. It is known that fear of falling predicts falling among elderly people. The aim of this study was to find out the possible relationships between the perceived effects of health exercise interventions and fear of falling.

Methods A questionnaire consisting of questions about demographic and socioeconomic status, intervention group, physical activity habits, perceived effects of intervention and general well-being was mailed to 2563 participants of health exercise program in April 2015. The response rate was 32.5% (78% women and 22% men). The data were analysed by descriptive statistics, correlation and t-tests, and binary regression analysis.

Results Of the respondents, 22% had fallen during the last year and 65% of them experienced fear of falling. There were no differences in reported falls and fear of falling between the genders. Fear of falling predicted falls when age was taken into account (OR = 2.660, p = 0.000). The older the respondent was, the more participation in the intervention reduced the fear of falling (Spearman’s rho 0.093, p = 0.036). Fear of falling reduced more among those who participated in the exercise group twice or more times per week than once or less times per week (t₍₅₂₃₎ = 2.933, p = 0.004). If the participation in the exercise group was felt to improve physical condition (OR = 3.592), balance (OR = 4.439), muscle strength (OR = 2.810), or mood (OR = 3.660) to some extent or more, it predicted reduction in fear of falling when adjusted for age (all p-values 0.000).

Conclusions Tailored health exercise interventions may reduce perceived fear of falling among elderly people and, in that way, decrease the occurrence of falls.