How to Reduce Your Falls Risk
A quote I quite like is from an interview where a fellow was turning 100...
He had just received the Queen’s letter and was sitting there with a big smile when the interviewer asked, “So what is the secret to your longevity?” I was expecting him to say “staying single,” but what he actually said was:
“The reason I am still alive is because I haven’t died yet!”
Whilst this seems a bit cheeky, the deeper meaning I took from this is quite profound. To me, I understood this as him saying that the reason he is still alive is because he hasn’t stopped living. People are living well into their 70s and are not dying until our 80s, 90s and 100s. 20% of our population is 65 and over! yet sadly, many people stop living well before they die.
Ageing or inactivity?
Research into ageing has heavily focussed on the general decline in the ability to do physical work and remain independent. What we have learned over the past 30-40 years is that approximately half of what was previously attributed to the ageing process is actually due to inactivity!
That is, if you do not remain active, you will decline at twice the rate as someone who is. Studies also show that the more medication you are on, the more important it is to be active.
The biggest factor determining your risk of falling is your functional ability, which can be affected by reduced balance, reduced strength or trouble walking (gait problems).
How common is falling?
A fall is when you unintentionally end up on the ground or lower level. They are not caused by fainting or sudden illness, an act of man or act of nature, but could be when, for example, you stand up from a chair and fall back onto the bed.
Above the age of 65, 1 in 3 will fall each year. Your risk increases as you get older, with half of adults aged over 80 falling each year. In fact, falling is the fifth-highest cause of death in over 65s, with 10% of falls leading to major injury.
Fractures are a common injury caused by falling, and are more likely to occur in women. Other serious outcomes can include brain trauma and hospitalisation, not to mention that 60% of fallers go on to have reduced social and physical activity.
Falling risk factors
The biggest factor determining your risk of falling is your functional ability, which can be affected by reduced balance, reduced strength or trouble walking (gait problems).
Your medications can also increase your risk, particularly if you are taking four or more medications of any sort, particularly sleeping pills, antidepressants or antipsychotics.
Other risk factors include being very thin, visual impairment and other health conditions such as diabetes, dizziness, depression, dementia, incontinence, arthritis and pain.
Studies have shown that if you have four or more risk factors, you have an 80% chance of falling within the next year. This is a confronting reality, however there is no reason to fear. Quite simply, if you reduce your number of risk factors, you can reduce your risk of falls. And the good news is that your GP, physio and exercise physiologist can help you do something about many of these factors to reduce your risk. There is also a lot that you can do at home!
Exercise can be started safely at any age
We can’t prevent all falls, but we can certainly reduce the number and frequency of falls and reduce the severity of the fall.
The natural instinct is to reduce physical activity as you age, which leads you to decondition and decline, which actually increases your risk of falling. To reduce the risk factors of poor balance, gait and strength, you must get some more exercise in. You may already be walking, but I would recommend adding a strength and balance program.
Take a look at these Olympic records below:
Imagine if I went up to these 1896 winners and said, “my grandpa could beat you!”
And look at the marathon runner - If they ran the same race, the 60+ year old male would be back at the bar and through his first round at happy hour as the 1896 runner finished!
The reason I use this is to remind everyone about ageism and what we in our minds convince ourselves is not possible.
I know what you are thinking: you are sitting their thinking “they are probably all American drug cheats,” or you may be thinking that you are too old to start.
But my encouragement to you is that those who have not been active have the most to gain. You may think “I’ll see how I go…”
Well, what are you waiting for? what better time than now to improve your health and physical capabilities?
Often people don’t realise just how good they can be and are limited by the perception of what an older person should or could be doing. You have worked hard you whole life to retire and live less.
It is about being regularly active: doing things you love like spending time with family and friends, starting hobbies, having pets. These are the secrets to staying alive, and more importantly to really live while we are alive. So it should not be a question of how long does one live, but how long does one live well.
You could try tai chi, yoga, specific balance or strength programs or whatever you enjoy really. Just make sure that whatever you do has some sort of balance component.
Falls Prevention Exercises for Home
Sit to stand
Practice getting up and down from a chair to improve your glute, quad and calf strength.
Focus on pushing up through your heels as you stand. If you can, try to do it without holding on to anything, but it is ok to start with holding onto the sides of the chair for support.
Try 3 sets of 10 repetitions a few times per week.
In order to improve, we assume that it is going to hurt and perhaps even be absolutely exhausting. But a modest increase in daily activity will significantly improve health and quality of life for most people.
Calf raises
Holding onto a kitchen bench with both feet planted on the ground, slowly raise both heels as high as possible and then lower them back down to the ground.
Repeat this for 3 sets of 10 repetitions a few times per week.
As you get stronger, you can progress to single leg raises.
Balance exercises
Starting at the age of 40, we start losing function in our inner ear, that will affect our balance. Part of this is due to the fact that we stop using it, since we stop moving our heads as much.
Our vision gets poorer as we age, and our peripheral vision gets narrower, but the interesting thing is that we tend to have to rely on it more, because we turn our head less.
One thing you can do that costs you nothing, doesn’t get you sweaty or mess up your hair is to turn your head more.
Stand up and turn your head up and down then repeat with your eyes closed.
Doing 5-10 minutes of balance work every day will significantly reduce your risk of falling.
While this is a great place to start, it can be very general. Our accredited exercise physiologists at MVP can work with you either by doing some one-on-one sessions here in the clinic, or can provide you with a program that will help you get the best out of your exercise.
Reducing your other risk factors
With medication posing a significant falls risk in many cases, it is worth considering if you could review your needs with your GP. Sometimes medication gets started but is no longer needed, or may not work as well for you as they do for other people.
While you are at your GP, it’s worth getting a check up, particularly examining your eyes, feet, heart, brain and nervous system (all of which can impact your falls risk) and to deal with any concerns accordingly.
If you have any particular pain or conditions such as arthritis, it might be worth getting some physiotherapy treatment to help improve your mobility and functional capacity, and also just to improve your quality of life.
Another great tip is to make sure you are getting enough vitamin D, either through over the counter supplements or sunlight. While we don’t all need it, many frequent fallers are deficient in this nutrient, and increasing your intake can reduce your risk of falls and fracture.
Finally, consider if you live in a “fall-proof” home. Things like cables and rugs can present a trip hazard. Ensure that you have good lighting in your house and grab rails in necessary locations to help you move about your home more easily.