Exercise and Fall Prevention: A Balancing Act

Senior woman looking out the window, feaful.

It happened so suddenly! Rose was walking across the mall parking lot, tripped on a bit of rough pavement, and down she went. After checking the x-rays, the doctors at the emergency room assured her that nothing was broken, but she went home with some pretty nasty bruises — and, with a fear of falling that motivated her to stick close to home. Pretty soon, Rose noticed that couldn't walk as fast as before, she felt less steady on her feet, and she had gained 15 pounds. Her doctor assured her that the fall itself hadn't caused her reduced mobility — instead, her less active lifestyle after the fall had resulted in decreased muscle strength and balance.

When we think of life-altering health events, we usually think of illnesses. Yet, said Dr. Mary Elizabeth Tinetti of Yale School of Public Health, "Falls are one of the most common health problems experienced by older adults and are a common cause of losing functional independence. Given their frequency and consequences, falls are as serious a health problem for older persons as heart attacks and strokes."

How frequent? According to the Centers for Disease Control and Prevention (CDC), 25 percent of all seniors will suffer a fall each year, and many of them sustain brain damage, a hip fracture, or other injury so serious that they never regain their full independence. There are 28,000 fall-related deaths among seniors each year.

So yes, falls are very serious. We want to do all we can to avoid them! But if we yield to the temptation to spend all our time "safely" sitting on the couch, a downward spiral can quickly begin. Inactivity causes a rapid decline in a senior's abilities. Most of us know that exercise is good for our hearts, brains and every other system of the body, but we should also keep in mind that exercise also is an important factor in preventing senior falls—the No. 1 factor, according to the U.S. Preventive Services Task Force.

Fall risk and exercise—a balancing act in more ways than one!

Today, organizations that provide care for seniors weigh the benefits of exercise with the need to protect against falls. Hospitals that not so long ago did their best to confine patients to their beds now recognize that even a few days of immobility can cause functional decline in older patients, raising the risk of blood clots, delirium, weakness — and, the risk of falling.

Nursing homes and other senior living communities also are weighing fall risk against the risk of immobility and decline. A recent study from Harvard Medical School noted that the nursing home residents who are at highest risk of falling are, ironically, those who are the most independent — yet physical activity helps keep them independent in the first place! This underscores that fall prevention is an important part of the care they provide.

In the face of this fall risk conundrum, what should seniors and their families do to reduce the risk of falling while promoting more physical activity?


Senior woman in exercise class

Rose signed up for a fall prevention class, and soon she was stronger, had her energy back, and felt confident exercising again.

Begin with a fall risk assessment. Your doctor can test your balance, muscle strength and flexibility. Discuss your fall history, and any health conditions that could raise your risk, such as incontinence, arthritis, osteoporosis, inner ear problems, or mobility challenges.

Ask the doctor to review your medications. Some drugs that lower our risk of falls by improving certain health conditions might also have side effects that could raise our fall risk, such as dizziness and drowsiness. Your doctor will weigh the benefits and risks of these medications. Be alert for side effects, and report them right away.

Have your eyes checked. Everyone older than 65 should have an eye exam at least once a year. Your eye care professional can tell you if you have vision problems that might raise your risk of falls. Your eyeglass or contact lens prescription should be updated regularly. And did you know progressive or bifocal lenses could be a fall risk? Consider getting a distance-vision-only prescription for use during workouts and walking.

Get an exercise "prescription." Your doctor can recommend activities that improve your balance, such as tai chi, gait training and other balance exercises—even ballet. And balance activities are only the beginning. Aerobic, muscle strengthening and stretching exercises make us more strong and limber, more able to avoid falling, and less likely to be injured if we do fall. If you have health and mobility challenges, your doctor can recommend appropriate adaptive exercises.

Give your home a fall-prevention inspection. Maybe you like to exercise at home, setting up a treadmill or home gym, or working out to videos or DVDs? House cleaning, gardening and other household tasks can also provide a good dose of physical activity. So take an appraising look at the spaces where you do these activities. Be sure they are free from clutter that could trip you up. Watch out for loose carpet, slippery floors, or a missing patio paver. Improve lighting throughout the house, and add contrasting strips of color to stairs.

Get some great shoes. When we think of the risk factors for falls, few of us would put shoes high on the list — but in fact, inappropriate footwear can trip us up. Orthopedists say that for seniors, the exercise they're doing and the health of their feet both factor in when selecting the best shoe. For example, shoes that are perfect for the wood floor of a gym might become slippery on wet pavement. It's best to let an expert help with your choice.

Listen to your body. If you have mobility challenges due to osteoporosis, arthritis, stroke or other condition, be aware of how you're feeling from day to day, and how confident you're feeling as you exercise. Even a temporary illness might mean it's good to take extra precautions. Experts from the Infectious Diseases Society of America reported that urinary, bloodstream or respiratory infections can raise our fall risk by causing low blood pressure, dizziness and confusion.

Be aware of your surroundings. Get in the habit of scanning both down toward the sidewalk and up into the distance, much as you would when driving. If you like to go for a neighborhood walk, take notice of places where the pavement is uneven. If you're in a public place, never assume that someone has cleared all the clutter! And it goes without saying that you shouldn't text and walk.

Source: Kentuckiana Regional Planning & Development Agency (KIPDA) in association with IlluminAge Communication Partners; copyright 2017 IlluminAge