Preventing Falls as we Age

1 in 4 older adults falls each year

As we age, maintaining independence, mobility, and overall health becomes increasingly important. According to the Centers for Disease Control and Prevention (CDC), 1 in 4 older adults falls each year, and these falls can have serious consequences, including injury, disability, and even death. The good news is that through a combination of strength, balance, and proprioception exercises, as well as other strategies, falls are largely preventable. Preventing falls is typically the domain of physiotherapists.

What are some factors that increase my risk of falling?

There are many factors that contribute to a higher risk of falling, many of which can be improved. The following are some things that may play a role:

• Some medications can cause side-effects such as drowsiness, light-headedness or dizziness which can increase your fall risk.
• Eyesight plays a key role in balance and is important for detecting risks that increase your likelihood of falling.
• Wearing poorly fitting or inappropriate footwear increases your chances of stumbling or tripping.
• Having decreased strength and poor balance significantly increases your fall risk.
• Certain medical conditions such as some neurological conditions including Parkinson’s and Multiple Sclerosis can make you more prone to having a fall.
• Clutter around the home, particularly when objects are left in walkways is a significant factor in increasing fall risk.

Can you do these 5 activities that indicate lower fall risk?

• Are you able to stand on one leg for over 10 seconds?
• Can you stand up from a chair without using your hands to push-up?
• Can you stand with your feet touching and your eyes closed for 10 seconds?
• Are you able to walk in tandem (heel to toe in a straight line?)
• Can you stand up from a seated position in a chair, walk 3 meters, return to the start position, and sit back down in less than 12 seconds?

What can I do to help in preventing falls?

• Improve strength

There is profound evidence that physical exercise can lower the risk of falling in older people. Lower limb and core strength are particularly important in reducing fall risk. Studies have shown that physical exercise is effective in improving static and dynamic balance and reduces the number of falls for patients aged 65 or over. A meta-analysis by Papalia et al, reported strong evidence that exercise programs can reduce fall rates in the geriatric population.

• Improve proprioception and balance

Proprioception is your body’s ability to sense where it is in space – having a good sense of proprioception and balance is crucial to reducing the risk of falling and increases your ability to regain your balance in the case of tripping on something. A large research study by Sherrington et al, that examined close to 8,000 older adults found that balance and functional exercises reduced the rate of falls by 24%. It is recommended that balance and postural exercises should be incorporated into training programs for older adults, as well as for the overall healthy population.

Have an assessment with a healthcare professional

There are a series of tests that a physiotherapist can do to determine whether you are at a higher risk of falling. If you have had a fall in the last year, or if you have been feeling unsteady on your feet, it is worth making an appointment to have an assessment. Your physiotherapist will be able to provide a progressive programme to decrease your risk of falling and re-assess you along the way to ensure improvement.

An occupational therapist can carry-out home assessments to advise on helpful equipment such as grab bars and seat raisers, as well as check for hazards around the home and modifications that can be made.

As good eyesight is crucial in reducing fall risk, it’s important to consult with your doctor or optometrist if this is a concern for you. You should also discuss side effects of any medications which you may be taking, particularly if you have been feeling light-headed or dizzy.

Having osteoporosis increases your risk of breaking a bone when you fall, therefore it is crucial to determine whether this is a risk factor for you and have medical management for osteoporosis if necessary.

Modifications around the home

The following are some recommendations of modifications that you can make around the home to help decrease the likelihood of having a fall:

• Remove clutter, particularly excessive or unnecessary objects that take up floor space.
• Modify furniture layout, including removing rugs and side tables that may get in the way.
• Modify positions of light switches and lamps as well as intensity of lighting where possible. You should have a lamp or light switch by your bed so that you don’t have to walk in the dark when going to bed or getting up to use the toilet in the night.
• Install adaptive equipment such as grab bars in the shower and handrails along stairs.
• Use non-slip flooring particularly in areas that frequently get wet.
• Clean-up any spills immediately.
• Keep frequently used equipment such as kitchen utensils in easily accessible places.
• Keep electrical cords away out of the way of any walking paths through the house.
• Be aware of your pet – often people trip on their cat or dog in the house.
• Make sure chairs are high enough to get out of easily.

Concluding the key aspects of preventing falls

Fall prevention is a crucial aspect of maintaining health, well-being, and independence, especially as we age. By incorporating balance, functional and strengthening exercises into daily routines, creating safe environments, and staying active, we can significantly reduce the risk of falls. Education, awareness, and regular health check-ups are key to identifying potential risks and addressing them before they lead to injury. A proactive approach to fall prevention not only improves quality of life, but also promotes independence and confidence in everyday activities.

CITATIONS

1. Papalia GF, Papalia R, Diaz Balzani LA, Torre G, Zampogna B, Vasta S, Fossati C, Alifano AM, Denaro V. The Effects of Physical Exercise on Balance and Prevention of Falls in Older People: A Systematic Review and Meta-Analysis. J Clin Med. 2020 Aug 11;9(8):2595. doi: 10.3390/jcm9082595. PMID: 32796528; PMCID: PMC7466089.
2. Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. The Cochrane database of systematic reviews, 1(1), CD012424. https: / /doi. org/ 10. 1002/14651858.CD012424.pub2