According to the National Council on Aging, falls are the leading cause of fatal injury and nonfatal trauma in older adults and are increasing. In fact, results from a recent study published in JAMA show the rate of fatal falls among adults over 75 doubled between 2000 and 2016.
Siobhan McMahon with the University of Minnesota School of Nursing explains how physical activity in older adults can help prevent falls and related injuries.
Q: What are the risk factors for injurious falls among older adults?
There are many factors that increase our chances of falls and injuries as we age. The most significant and modifiable risks include changes in gait, balance and leg-strength; osteoporosis; use of fall-risk increasing medications; postural hypotension; foot problems; unsafe footwear; home-environment hazards; and vision problems. According to the Centers for Disease Control and Prevention, deaths from unintentional injuries are the seventh leading cause of death among older adults, and falls account for the largest percentage of those deaths.
Q: What are injuries associated with falls?
One in four adults—over the age of 65—falls each year. Approximately one out of five of these falls results in serious physical injury, such as concussion or hip fracture. Wrist, arm, leg and ankle fractures are also common. Many people who experience a fall, with or without a physical injury, also develop an increased fear of falling and limit their activities.
Q: How does physical exercise help prevent falls in older adults and related injuries?
Regularly performing balance-challenging and leg-strengthening exercises reduces fall risk. In particular, when a person performs balance-challenging exercises (e.g., heel-toe stands, one-leg stands, heel toe walking—with support as needed ) at least three times per week and leg-strengthening exercises (e.g., leg extensions, knee flexion, calf raises, toe raises) at least two times per week. These exercises increase an individual’s balance and strength, thereby reducing their risk of falling by up to 40 percent. Physical therapists can help individuals individualize a program of these fall-reducing exercises. Additionally, there are many community resources that include instructions and guidance to perform such exercises within a program (e.g., Tai Chi, SilverSneakers, Fit&Strong!) or at home (e.g., Go4Life).
Q: What can friends, family, health care providers and caregivers do to help prevent or reduce the risk of falls?
Friends, family, health care providers and caregivers can help prevent or reduce the risk of falls by encouraging and helping older adults to address their fall risk. This can be accomplished by assessing and discussing fall risk with their provider(s), having medications reviewed by a pharmacist, practicing leg-strengthening and balance-challenging exercises, getting an eye exam, and making their home safe, e.g. non-slip mats and grab bars in bathtubs. The CDC has excellent assessment guides for individuals, caregivers, and health care professionals, as well as fall prevention action guides for individuals, caregivers and health care professionals.
Q: How is your research working towards improving fall prevention in older adults?
I am currently involved with two studies designed to examine intervention effects on falls among community-dwelling older adults. The first study, Community-based Intervention Effects on Older Adults Physical Activity and Falls, addresses the limited translation of evidence in the fields of falls prevention and physical activity. Despite evidence that physical activities targeting leg strength and balance reduce fall risk, less than 12 percent of older adults engage in these activities as recommended and fall rates continue to increase. The objective of this study is to identify specific intervention components ( a.k.a. behavior change strategies) that motivate older adults to sustain increased levels of physical activity. This work will advance knowledge about how best to promote fall-reducing physical activity among older adults.
The second study, Strategies to Reduce Injuries and Develop Confidence in Elders is designed to evaluate the effectiveness of an intervention comprised of multiple evidence-based strategies to reduce fall related injuries. This intervention is delivered by registered nurses in primary care settings. Results from this study will help health care systems determine whether proven fall reduction strategies reduce the occurrence of injurious falls among older adults.
Siobhan McMahon is an associate professor in the School of Nursing and a cooperative member of Adult and Gerontological Health. Her research focuses on promoting health and wellness in older adults, especially those at risk of falling.