Balance decreases with age, but exercise can help reduce the risk of falls in part
My wife and I were at the grocery store recently when we noticed an elderly woman reaching beyond her head for some fruit and veg.
As she stretched out her hand, she lost her balance and began to fall forward. Luckily, she was leaning into her shopping cart, which kept her from falling to the ground.
About one in four older adults falls each year. In fact, falls are the most common cause of injury in adults aged 65 and over. Falls are the leading cause of hip fractures and traumatic brain injuries.
Such injuries are also risk factors for being placed in a nursing home, where the risk of falls is almost three times higher than for people living in the shared apartment.
A number of physical changes that occur with age often go unnoticed before falls, including muscle weakness, decreased balance and changes in vision.
I am a physical therapist and clinical scientist focused on fall prevention in older adults, typically ages 65 and older.
I have spent most of my career studying why older adults fall and working with patients and their families to prevent falls.
Why age leads to an increased risk of falls
Aging is a process that affects everyone’s systems and tissues. The rate and extent of aging can vary in each individual, but overall, physical decline is an inevitable part of life.
Most people think that aging begins in their 60s, but in fact we spend most of our lifespan going through the process of decline, which typically begins in our 30s.
Older adults are more prone to falls for a variety of reasons, including age-related changes in their body and impaired vision that make them vulnerable to environmental influences such as curbs, stairs and carpet creases.
Some simple steps to improve the safety of the home environment for older adults can significantly reduce the risk of falls.
Based on my experience, here are some common reasons for falls in older adults:
First, aging leads to a natural loss of muscle strength and flexibility, making it more difficult to maintain balance and stability. Loss of strength and loss of balance are two of the most common causes of falls.
Second, older adults often suffer from chronic conditions such as arthritis, Parkinson’s disease, or diabetes, which can affect their mobility, coordination, and overall stability.
In addition, certain medications commonly taken by older adults, such as sedatives or blood pressure medication, can cause dizziness, lightheadedness, or a drop in blood pressure, leading to an increased risk of falls.
Age-related visual impairments such as Ailments such as reduced depth perception and peripheral vision, as well as difficulty distinguishing colors or contrast, can make navigation and identifying potential hazards difficult.
Environmental hazards, such as uneven surfaces, slippery floors, inadequate lighting, loose carpets, or crowded pathways, can be a significant contributor to falls in older adults.
Older adults who lead sedentary lifestyles or have limited physical activity may also experience decreased strength, flexibility, and balance.
Finally, diseases such as dementia or Alzheimer’s can impair judgement, attention and spatial awareness and lead to an increased risk of falls.
theories of aging
There are numerous theories as to why we age, but there is no one single concept that explains all of the changes in our bodies.
Much of the age-related decline is caused by our genes, which determine bone structure and function, muscle growth and repair, and visual depth perception, among other things.
But there are also numerous lifestyle factors that influence our rate of aging, including diet, exercise, stress and exposure to environmental toxins.
A recent advance in the scientific understanding of aging is that there is a difference between your chronological age and your biological age.
Chronological age is simply the number of years you have been on earth. However, biological age refers to how old your cells and tissues are.
It is based on physiological findings from a blood test and is related to your physical and functional performance.
So if you are healthy and fit, your biological age may be lower than your chronological age. However, the opposite can also be the case.
I encourage patients to focus on their biological age because it gives them the opportunity to take control of the aging process. We obviously have no control over when we are born.
By focusing on the age of our cells, we can avoid the long-held assumption that our bodies are destined to develop cancer, diabetes, or other diseases that have historically been linked to our longevity.
And by taking control of diet, exercise, sleep, and other lifestyle factors, you can actually lower your biological age and improve your quality of life.
For example, our team’s research has shown that moderate aerobic exercise can slow motor decline even when a person begins exercise in their second half of life.
Lifestyle changes such as regular, long-term exercise can reduce the effects of aging, including falls and injuries.
Eating a healthy diet, managing chronic conditions, having medications reviewed by healthcare professionals, maintaining a safe home environment, and regular eye exams can also help reduce the risk of falls in older adults.
There are several exercises that physical therapists use to improve patient balance.
However, it is important to note that before beginning any exercise program, everyone should consult with a doctor or qualified physical therapist to determine the exercises that are most appropriate for their specific needs.
Here are five forms of exercise that I often recommend to my patients to improve balance:
Balance training can help improve coordination and proprioception, which is the body’s ability to recognize where it is in space. By practicing movements that challenge the body’s balance, such as standing on one leg or walking heel-to-toe, the nervous system becomes better at coordinating movements and maintaining balance.
A large research study of nearly 8,000 older adults found that balance and functional exercises reduced the rate of falls by 24%.
Strength training exercises include lifting weights or using resistance bands to increase muscle strength and power.
By strengthening the leg, hip, and core muscles, older adults can improve their ability to maintain balance and stability.
Our research has shown that strength training can also improve walking speed and reduce the risk of falls.
Tai Chi is a gentle martial art that relies on slow, controlled movements and shifting your body weight. Research shows it can improve balance, strength, and flexibility in older adults.
Several combined studies in Tai Chi have shown that the number of people suffering falls decreases by 20%.
Certain yoga poses can improve balance and stability. Tree pose, warrior pose, and mountain pose are examples of poses that can help improve balance.
It is best to practice yoga under the guidance of a qualified teacher, who can adjust the poses to suit individual abilities.
Flexibility training stretches muscles and joints, which can improve range of motion and reduce stiffness.
By improving range of motion, older adults can improve their ability to move more safely and avoid falls due to mobility impairments.
The use of aids can be helpful if strength or balance problems are present.
Research studies evaluating canes and walkers used by older adults confirm that these devices can improve balance and mobility.
Training by a physiotherapist or occupational therapist in the correct use of aids is an important part of improving safety.
When I think back to the woman who almost fell in the grocery store, I wish I could share everything we’ve learned about healthy aging.
There’s no telling if she’s already put these tips into practice, but I take comfort in the thought that maybe she avoided the crash by being in the right place at the right time.
After all, it was on the fruit and vegetable shelf.
Written by Evan Papa. The conversation.
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