Approximately one third of people aged 65 years and over living in the community fall at least once a year, with up to one fifth of these people suffering multiple falls. Increased susceptibility to falling is one of the most serious problems associated with ageing.Some risk factors for falls include:
- older age;
- a history of falls;
- poor balance;
- slow reaction time;
- muscle weakness;
- poor eyesight;
- reduced sensation in upper and lower limbs;
- limitations in activities of daily living (e.g. feeding and dressing oneself);
- medical conditions (e.g. stroke and Parkinson’s disease); and
- medication use (e.g. drugs that affect the brain, and multiple medications).
Almost three-quarters of people report slips, trips and loss of balance as the cause of their fall – that is, balance related factors that are amenable to change.
Developing strategies to prevent falls and fall related injuries is an important priority. Well designed studies have shown that fall rates are significantly reduced in community groups by: exercising, focusing on foot and ankle exercises especially balance training; maintaining vision; limiting medication that affect the brain; modifying the home where necessary; and continuing regular podiatric treatment.
There is good evidence that exercise prevents falls in older people, by decreasing a number of key risk factors. For example, exercise can improve muscular strength, balance, balance confidence and walking speed, as well as psychological factors such as mental ability and mood. Exercise is recommended for all community members.
Exercise programs should include balance training, be performed regularly, be of sufficient duration (at least 2 hours per week) and be ongoing. These factors increase the chance of the exercise preventing falls. Good balance exercises involve controlled body movements while standing with the feet close together or standing on one leg, with as little arm support as possible. The exercises should be safe, but should challenge balance and develop strength.
Tai chi is an effective form of exercise for fall prevention in healthy older people. Group based strength and balance classes can be monitored by professionals and are also a social occasion, but exercises can also be home based.
Here is an example of home based balance exercises:
- Heel-to-toe standing/walking
- Knee raises
- Side leg raise/sideways walking
- Heel raise
- Stepping up a step
- Sit to stand
Identification of factors that increase your risk of falling is vital for prevention of falls and injuries. FallScreen is the physiological profile assessment tool now used both clinically and in fall prevention trials throughout Australia and across the world, predicting elderly fallers with an accuracy of 75%.