Every year in the US, about one-third of people age 65 and older fall, with 1.6 million treated in emergency rooms and 12,800 killed. But falling is not an inevitable result of aging.
Falling is associated with impairments (such as from stroke, gait or vision problems, or dementia) that are more common with age. But risk of falling is also increased by poor balance and muscle strength and by side effects of certain drugs, especially those prescribed for sleep and depression.
Balance training and strength training are often underutilized ways to prevent falls.
With some types of balance training, you move continuously while simultaneously “perturbing” your center of gravity — that is, you intentionally become off-balance during movement, and your body learns how to respond, building your sense of balance. Do not try this on your own. Balance training is taught by physical therapists at many rehabilitation centers.
Another type of balance training is tai chi. This meditative martial art combines gentle, flowing movements with breathing and improves balance with moves that shift weight and increase awareness of body alignment. Teachers don’t have to be licensed, so look for one with at least five years’ experience.
Surprising: Dancing is a form of balance training. Any type will do, including ballroom, polka or salsa. Take lessons — and go out dancing!
In strength training, you build lean muscle mass by using your body weight (in squats, push-ups and ab crunches), free weights or elastic bands, all of which provide resistance to muscular effort. Stronger muscles and good balance often make the difference between a stumble and a fall.
You can safely learn strength training at a health club with a certified instructor who can correct your form and modify moves as needed. To do these exercises at home, use a book or DVD by a certified instructor, but check with your doctor first.
Caution: If you’ve had two or more falls in the past year, or feel unsteady on your feet, see a doctor for a referral to a physical therapist, who can create a safe balance- and strength-training program for you.
Several types of widely prescribed drugs have been linked to an increased risk for falls, including…
Important: Taking five or more medications also is linked to an increased risk for falls.
Side effects of several medications (including drugs for Parkinson’s disease, diuretics and heart drugs such as beta-blockers) may increase the risk of falling by causing postural hypotension (blood pressure drops when you stand up from lying down or sitting). Not enough blood flows to the heart to keep you alert and stable, and the body’s normal mechanism to counteract this fails.
What to do: Ask your doctor to test you if you have symptoms, including feeling light-headed or dizzy after standing. He/she will have you lie flat for five minutes, and then check your blood pressure immediately when you stand up. You will remain standing and have your pressure checked one or two minutes later. If systolic (top number) blood pressure drops at least 20 mmHg from lying to standing, you have postural hypotension.
If this is the case, ask about reducing your dosage of hypertensive, antidepressive and/or antipsychotic medications — the three drug types most likely to cause this condition.
Also: Drink more water — at least eight eight-ounce glasses a day. Dehydration can cause postural hypotension and is common among older people, who have a decreased sense of thirst.
Helpful: When you wake up in the morning, take your time getting out of bed. Sit on the edge of the bed for a few minutes while gently kicking forward with your lower legs and pumping your arms. This will move more blood to your heart and brain. Then stand up while holding on to a nearby stable object, such as a bedside table.
Vitamin D promotes good muscle strength, so people with low blood levels of vitamin D may be at increased risk for falls. If your level is below 30 ng/mL, ask your doctor about taking a daily vitamin D supplement.
