According to the Centers for Disease Control and Prevention, 1 in 3 Americans, aged 65 and older, fall each year. More than half of those will experience more than 1 fall within a year. Twenty to thirty percent of those who fall will sustain moderate to severe injuries, and less than half actually tell their doctor.
Falls is considered a leading cause of both fatal and non-fatal injuries in older Americans. A severe fall can lead to debilitation, causing a decline in independence and function. Several factors are associated with a greater risk for falls. These include:
Intrinsic
- Age
- History of previous falls
- Disease state
- Compromised nutritional status
- Taking more than 4 medications
- Physical impairments (poor balance, weakness, impaired sensation, pain, visual deficits, decreased range of motion, decreased endurance, and difficulty walking)
Extrinsic
- Clutter
- Throw rugs
- Footwear
- Pets
- Lack of railings or grab bars
- Unstable furniture
When a toddler or a child falls, he or she can usually get up, shake it off, and keep moving. But when an older adult falls, there are usually consequences. Each year, at least 250,000 older people are hospitalized for hip fractures, and thousands actually die from it. Fifty percent of fallers are unable to return home or to independent living. Fractures and head injuries due to falls can knock confidence and instill a fear of falling again. A fear of falling can cause a person to cut down on their everyday activities, which results in social isolation. A less active lifestyle will cause bones and muscles to weaken which increases the risk of falling again.
Poor balance is the cause of the majority of falls in older adults. Postural control requires keeping your center of gravity over your base of support. Human balance depends on the interaction of 3 major systems: somatosensory, vestibular, and visual. The somatosensory system works to inform us about objects in our external environment that we can touch. The vestibular system gives us a sense of movement and orientation in space relative to our head position. The visual system gives us the ability to process visual detail.
The risk of developing problems in one or more of these systems increases with age as the body is exposed to degenerative diseases or an accumulation of injuries sustained over a lifetime. With one or more of these systems compromised, an individual may become more susceptible to a fall.
These systems can be strengthened and improved to reduce falls associated with loss of balance. Structured exercise along with balance training can help reduce the risk of falls and prevent fall-related injuries. Benefits of a multi-component exercise program include:
- Faster reaction time: this can help keep yourself upright if you start to fall by putting out your arm quickly to grab something stable
- Improve coordination: can help you roll rather than crash as you go down
- More muscle: stronger and larger muscles can lessen the impact of a fall by protecting your bones and joints
- Stronger bones: through resistance exercises, you can make your bones more resistant to injury
- Better brain function: regular exercise can allow clearer thinking, which helps avoid situations that put you at a risk for a fall
Balance is a complex coordination of many systems in the body. Together with your doctor, your physical therapist can determine what system may be weakened or impaired, and better focus will be placed on where it’s needed. Additionally, your physical therapist will perform a gait evaluation to determine if you need assistance (cane, walker, etc.) when walking to prevent falling.
Two-thirds of all falls are estimated to be preventable. Efforts to prevent falls are best when started early in life. However, you are never too old or frail to exercise. There are always exercise programs to fit your needs. Take charge of your health and balance your way to fall prevention!
References:
https://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html
