Falls can happen to anyone at any point in their lives, however as we age falls become more and more common, and the risk of serious injury as a result significantly increases also. Falls are a major health issue with 1 in 3 community dwelling older adults experiencing at least one fall every year, with even higher rates for those in residential care facilities and hospitals.1 This number is only set to increase as Australia’s population ages with the proportion of people aged over 65 predicted to increase from 14% in 2010 to 23% in 2050.2
Falls are the leading cause of injury-related death and hospitalisation in this population. An older adult is 3 times more likely to be admitted to a nursing home after a fall, and over 10 times more likely if the fall caused an injury. Falls are the biggest cause of disability, reduced quality of life and loss of independence in the elderly. 3 This is because falls often result in injuries that have both physical and psychological consequences including loss of mobility experienced as a result of sustaining physical injury, as well as a loss of confidence in their own ability to prevent future falls. As a result older adults often reduce their physical activity levels, which only increases their risk of a future fall through deconditioning and a further loss of confidence. It is therefore it is important to understand what may cause a fall, consequences of falls and what can be done to prevent falls from occurring.
For an older adult to balance and walk without concern it requires multiple different parts of their body to communicate and respond appropriately. Walking requires freely moving joints, appropriate muscular contraction and strength with appropriate timing, accurate vision and proprioception all at once. As we age these functions can become compromised due to many reasons such as arthritis and stiffness of the joints, age related loss of muscle mass, strength and coordination due to inactivity, poor vision, other medical conditions etc. These changes combined with other factors such as history previous falls, use of psychoactive medications, and other medical conditions significantly increases the likelihood of a fall. The strongest independent risk factors for falls are previous falls, weakness, gait and balance impairments, and use of psychoactive medications.1
Contrary to popular belief, falls among the elderly are not inevitable and many falls can be prevented. Some risk factors for falls are relatively easy to change and control such as consulting your doctor about medications and any changes to your health, getting regular eye checks and being conscious of your environment. However one of the most effective methods to prevent falls is structured exercise focusing on improving muscle strength, balance and coordination.
Exercise as a single intervention has been shown to prevent falls in community-dwelling older people5, with the most effective exercise interventions identified as group-based programs that included two or more exercise components, individually tailored programs delivered in the home, and community-based Tai Chi programs. 4
Exercise and Sports Science Australia (ESSA) recommends that older adults should participate in a structured exercise program that focus on challenging balance through controlled movements with minimal arm support, changes in foot position andcontrolled movements of the body’s centre of mass. The most effective programs are those that are performed for a minimum of 2 hours each week and are ongoing with continuing progressions. It is important to note that walking on its own will not prevent a future fall, and a successful falls prevention program will be tailored to the individual’s needs and level of falls risk. 6
It is important to emphasize that these programs not only focus on improving physical capabilities but also assist to build confidence and self-efficacy within older adults to truly promote falls prevention among this population.
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