It is well known that older adults are more susceptible to falls than younger individuals. Many of us know someone who has experienced a fall at some point in their life. In this blog, we will explore why older adults are at greater risk of falling and how physical therapy can help reduce this risk.
Unfortunately, over 30% of people over the age of 65 experience a fall each year, and this increases to 40% for those over the age of 85. About 10% of these falls result in serious injuries, making it essential to understand why they occur and how best to prevent them.
There are numerous risk factors for falls in older adults, with a history of previous falls being one of the strongest indicators. This makes sense, as the factors that contributed to an initial fall often persist, increasing the likelihood of future falls.
While many are familiar with conditions like osteopenia or osteoporosis (the decrease in bone density that occurs with age), a related condition called sarcopenia also plays a significant role in fall risk. Sarcopenia is the loss of skeletal muscle mass that occurs as we age. As muscle mass decreases, it becomes harder to prevent a trip from becoming a fall due to the strength needed to catch yourself. This challenge is further compounded by slower reaction times in older adults.
Obesity is another risk factor, as it often accompanies muscle loss while adipose tissue increases. Other contributing factors include impaired vision, cognitive impairments like dementia, and the use of multiple medications (especially if taking four or more regularly).
Although not all risk factors can be changed through physical therapy, exercise can improve key areas that help mitigate fall risk. When a patient visits a physical therapist, several assessments are performed to gauge their fall risk. These tests may include the Berg Balance Test and Functional Gait Assessment, which evaluate balance during both static and dynamic activities. Lower extremity strength is also assessed, as it is crucial for maintaining balance and preventing falls.
Based on these assessments, a personalized treatment plan is created to target the specific areas that need improvement.
One of the main areas of focus in fall prevention is improving balance and proprioception. Proprioception is the body's ability to sense its position in space without visual input. Various balance exercises can help improve this, such as standing with a narrow base of support (e.g., a tandem or "tightrope" stance) or standing on one leg. Balance training can be further challenged by using unstable surfaces, like foam pads, to make the activity more difficult. Because many falls happen at night, balance exercises can also be practiced with eyes closed to mimic situations where vision is limited.
Strengthening the quadriceps, hamstrings, glutes, and calves is crucial if weakness in these muscles is detected. As people age, they may reduce or stop their strength training routines, which can accelerate muscle loss. It is important to maintain strength levels, as strong muscles are key to catching oneself during a loss of balance. Strength training for older adults doesn’t need to differ significantly from typical routines and can include exercises like squats, deadlifts, and lunges. These exercises are especially beneficial for individuals concerned about osteoporosis, as they help slow bone loss while building strength.
An often overlooked aspect of fall risk is the challenge of maintaining balance while distracted by the environment. Physical therapy can address this by incorporating dual-task training, where patients perform walking and balance tasks while simultaneously engaging in cognitive activities. This might involve walking heel-to-toe down a hallway while counting backward from 100 by sevens, or walking backward while scanning the environment side to side.
Although fall risk increases with age, it can be effectively managed through a thorough physical therapy assessment that identifies where balance difficulties stem from, followed by a comprehensive, personalized rehabilitation program. If you or someone you know is struggling with falls or balance issues, schedule an appointment today. Our experts at Maven are here to help you regain confidence and safety in your mobility.
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