Preventing Falls

Some new recommendations regarding fall prevention (meaning “falling down” rather than the season Fall) have recently been published in the Journal of the American Medical Association (JAMA).  This has been a topic of previous blog posts here and elsewhere, but new guidelines were issued in April 2018 by the U.S. Preventive Services Task Force (USPSTF) so it seems worth revisiting.  The USPSTF is a group of nationally recognized experts on evidence-based medicine and primary care appointed by the government’s Agency for Health Care Research and Quality (AHRQ).

The USPSTF conducted a review of 62 studies evaluating various interventions among older adults at risk for falls.  They found that of the interventions studied, exercise tops the list by “significantly reducing the risk for experiencing a fall”.  Although specific types of exercise were not highlighted, group exercise was included in the majority of the studies reviewed.  According to the review, “initial, exploratory analyses suggest that group-based exercise (vs individual-based exercise), [including] multiple exercise components (vs single exercise component), and . . . strength or resistance exercises . . . were more likely to be associated with a greater reduction in falls and number of persons experiencing a fall.”

The reason for the effectiveness seems to be the strengthening effects of exercise.  But I would add some additional possibilities, particularly relevant to yoga, Pilates, Tai Chi and other practices which focus on connecting mind to body.   These include an emphasis on training your mind as well as your body to pay attention to what’s happening right now in this moment.  Practitioners are encouraged to learn how their bodies work and to gain greater awareness of their surroundings as they move through space.  We call that “proprioception.” Balance training is also inherent in all of these practices in addition to strength training.  Also, group exercise has the added benefit of a social component.  This may seem like it would not be relevant to fall prevention, but I would contend that it has an impact on all aspects of one’s life, including continued mobility both physical and mental.

Falls are something we all worry about, especially as we age, but they can be devastating at any age.  According to USPSTF

“Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, nearly 29% of community-dwelling adults 65 and older reported falling, for a total of 29 million falls. Of these, more than one-third necessitated medical treatment or restricted activity. There were an estimated 33,000 fall-related deaths in 2015”

Anything we can do to strengthen our resources against this danger is certainly worthy of our attention.  This provides just another piece of evidence to recommend regular exercise for everyone.  It’s never too late to start.  No matter how inflexible or out-of-shape you think you are, if you can move and breathe, there is some form of exercise that you can do.  Starting is the hardest part.  That requires a decision.  Every journey begins with the first step.  Take that first step and then add to it.  Gradually.  Start slowly and keep moving.  You’ll improve if you stick with it.  You might still experience a fall, but by building your strength, you may also find that you recover that much more quickly.  That’s certainly worth the effort.


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