Build your strength, balance, and flexibility to reduce your risk of falling
If you are over age 65 and living at home, you have a 29 percent chance of falling over the next year. About 10 percent of falls result in injuries, such as fractures or sprains, which require medical attention. In the US, fall-related emergency room and hospital visits cost $50 billion annually. Fear of falling can cause older persons to unduly limit their physical activity and experience lower quality of life. Happily, recent evidence shows that home-based and group movement programs can significantly reduce the risk of falls. Successful programs typically emphasize building muscle strength, balance, and flexibility and in so doing may reduce your fear of falling and improve your quality of life.
Dance-based and tai chi classes at your senior center
Physical exercise interventions can improve strength and balance and reduce the risk of falls of older people. Dance-based and tai chi activities might accomplish the same results. A new systematic review and meta-analysis included 29 randomized clinical trials of healthy older adults living in the community or in independent living facilities. The included covered activities that involved mind-motor functions, such as traditional dance forms (folk and ballroom dancing), as well as tai chi.
Overall, dance-based and tai chi interventions combined led to 37 and 31 percent reductions in the risk and rate of falling, respectively. Trials that had three or more sessions per week produced even greater declines in risk of falling and rate of falling (57 and 45 percent, respectively.) The interventions led to improved lower body strength, balance, and mobility, all of which could help reduce the risk and rate of falls. Compared to tai chi, more traditional dance forms produced greater gains in lower body strength and balance. Of note, attendance exceeded 80 percent in most of the trials, which is higher than that found in most exercise interventions. Traditional dance and tai chi classes offered through senior centers and independent living facilities might be attractive, effective, and low-cost ways to help older people avoid falling.
Loneliness and social isolation can increase your risk of falling
Falls cause unintentional injuries and death older people, creating a major health challenge. A new study from British researchers investigated whether loneliness and social isolation predicted risk of falling. Loneliness refers to the subjective feeling of social isolation. Social isolation refers to objective measures of social engagement. Data came from the English Longitudinal Study of Aging, a nationally representative sample of English people over age 50 years and their partners.
After adjusting for sociodemographic and health factors, participants living alone or with low social contact had significant 29 and 7 percent higher risk of a self-reported fall, respectively, over follow-up of up to 14 years. For falls that resulted in hospitalizations, the comparable increases in risk were 23 and 6 percent for participants living alone and with low social contact, respectively. Loneliness did not predict self-reported falls after accounting for socio-demographic and health factors. Thus, objective social isolation, especially living alone, most strongly predicted falls and falls that resulted in hospitalization. This finding might reflect less ability of older people living alone to create a safe home environment (such as keeping walkways clear of clutter and securing rugs) and a more sedentary lifestyle that leads to reduced balance and flexibility. Grown children might tactfully help their elderly parents maintain a clutter-free living space.
Keep moving to reduce your risk of falling
Health experts recommend between 150 and 300 minutes of moderate-intensity physical activity per week for older adults. Does this level of physical activity reduce risk of falls by older adults? Researchers in Australia answered this question with data for 7,139 participants with an average of 68 years in the Australian Longitudinal Study on Women’s Health. After adjusting for confounding factors, participants who reported getting 150—300 minutes of leisure-time physical activity per week had significant 26 and 20 percent lower odds of a non-injurious or injurious fall, respectively, during the previous 12 months. Similarly, participants who reported more than 300 minutes of leisure-time physical activity per week had significant 34 and 30 percent lower odds of a non-injurious or injurious fall, respectively, during the previous 12 months. In addition, compared to participants who reported no leisure-time physical activity, participants who reported brisk walking, or moderate-intensity physical activity, or moderate-vigorous physical activity had significant 19, 19, and 16 percent lower odds of reporting non-injurious falls, respectively. The health benefits of increased physical activity might include lower risk of falling.
Falls can be a big deal for seniors
Falls comprise a major source of illness, mortality, and medical costs for persons over age 65. A team of researchers conducted a review and meta-analysis of published studies including recent meta-analyses and randomized clinical trials that addressed risks of falls and interventions to prevent falls. Guidelines generally recommend interventions for persons who report a fall in the previous year, have a fear of falling, or have a gait speed of less than 0.8-1.0 meter/second (1.8-2.2 mph). Functional exercises designed to increase leg strength and balance constitute the first-line prevention in persons with average to high risk of falls. A meta-analysis of 59 studies showed that exercise-based interventions led to significant 23 percent average lower risk of falls compared to non-exercise control groups. Similarly, a meta-analysis of 43 randomized multi-component clinical trials showed a significant 23 percent lower risk of falls for person at high risk. Other interventions that focused on cataract removal surgery, multi-component foot care, and environmental modifications also showed similar significant reductions in risk of falls. Happily, for persons over age 65 in the US, Medicare covers many types of interventions that are available in clinics or through community organizations.
Exercise and multi-component interventions can help you avoid falling
The US Preventive Services Task Force recently updated a 2010 report that evaluated interventions to reduce the risk of falls for senior US adults. The associated evidence report analyzed 62 randomized controlled trials for three types interventions: 1) multi-component, 2) exercise, and 3) doses of vitamin D. Multi-component interventions involved several components (such as exercise, psychology, nutrition, medication management) individually or in groups that varied across studies. Exercise studies involved gait, balance, and functional training that varied across studies. Vitamin D doses varied from daily to every 3 months to once annually. Multi-component interventions had a significant 21 percent lower risk of falls compared to controls. Exercise interventions had a significant 11 percent lower risk of falls and a 19 percent lower risk of injurious falls. Vitamin D therapy had mixed results, with high doses predicting significantly higher risk of fall-related outcomes. This finding contradicts the previous Preventive Task Force recommendation for vitamin D therapy. Overall, multi-component and exercise interventions may help reduce the risk of falls for older Americans, while exercise interventions may reduce the risk of injurious falls.
What to do
If you’re a senior who is not getting much physical activity, consider how your quality of life would diminish if you were to fall and break a hip or leg. The good news: You can do something to reduce your risk of falling and hurting yourself. You’ve read about possible options. Pick one and get going.
