The number of elderly individuals who suffer severe injuries from falls is an emerging concern in healthcare, and a new study suggests that the risks can be greatly reduced by implementing specialized exercise interventions.
In a study published this week in the medical journal The BMJ, researchers conducted a review of published studies that focused on prevention efforts for elderly falls, and found that the best intervention to prevent nursing home falls and falls among elderly outside of care facilities was an exercise-based program.
The review found a number of programs that resulted in benefits, with those involving exercise-based interventions being highly effective.
Among 3,500 people in 16 trials Tai Chi was associated with a 28% reduction of falls and a 29% reduction in the risk of falling. Group exercise classes involving balance, retraining and muscle strengthening also reduced the rate of falls.
A CDC compendium of effective fall prevention created in 2010 and updated in 2015 also concluded exercise based interventions reduce falls and the risk of falls. The compendium also highlights the Otago exercise program, a specialized intervention implemented in New Zealand which reduced falls by 46%.
Researchers who conducted the review indiate it is also important to focus on risk factors for those who may be most at risk of suffering a fall, such as gait and balance. People with slow gait often have increased co-contraction, the activation of muscles like the quadriceps and hamstrings, causing increased rigidness when walking. This increases their risk of falls.
By focusing on physical risk factors, not just age, doctors can properly assign specific interventions to enhance enhance musculoskeletal function.
“Substantial interdisciplinary research provides the basis for effective recommendations that may help clinicians reduce falls among older people in the community,” wrote study authors. “However, implementation of recommendations into practice is poor.”
Other interventions may also be appropriate including, educational and behavioral counseling, vision correction, and nutritional supplementation with vitamin D and calcium.
Nursing Home Fall Risks
According to the World Health Organization, 28% to 35% of people over the age of 65 fall each year globally and the prevalence of falls increases with age. Research indicates 40% to 60% of falls in that age group result in major lacerations, fractures or traumatic brain injuries.
Overall, falls are the main cause of injury, injury related disability, and death in older people. The risk factors of suffering a fall increase with age, including vision impairment, cardiovascular health problems, diabetes, decreased strength and balance, and frailty and disability.
Research reveals healthcare was needed in 24% of fall cases and close to 95% of all hip fractures are caused by falls. Ninety-five percent of patients with a hip fracture are discharged to nursing homes. An estimated 40% of nursing home admissions are related to falls and 20% of those with a hip fracture die within a year.
An editorial published earlier this month concluded falls suffered by the elderly in nursing homes can often be prevented by other means than simply using bed alarms. The editorial highlighted the need for interventions a fall risk assessment, hourly staff checks, scheduled toilet breaks and close observation are more effective than bed alarms.