A task force that studied the best way to protect seniors from falling has come up with a surprising recommendation: exercise.
Unlike passive interventions such as taking vitamin D or calcium to help prevent fractures, exercise has been proven to be effective, and families should encourage their older loved ones to incorporate more movement into their lives, according to the report from the U.S. Preventive Services Task Force.
The panel's recommendation is for generally healthy adults who don't have osteoporosis, Parkinson's disease or dementia, and the authors say the exercise should be supervised.
"(This) can be done in group or individual classes and either at home or in the community. Patients should talk with their clinician about what exercise programs are best for them," Dr. Alexander Krist, a task force member who is a family physician in Fairfax, Virginia, told HealthDay News.
Falls are the leading cause of injury and death among senior adults. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, common reasons for falling include loss of balance, reduced muscle strength and slow reflexes, all of which can be forestalled or improved with exercise three times a week.
The task force did not recommend any specific types of exercise, but Krist said that any kind "that improves balance, the way someone walks and helps with completing common tasks are helpful."
The panel's report departs from previous recommendations that seniors take vitamin D supplements. The Centers for Disease Control and Prevention said in 2016 that physicians should advise their older patients to take vitamin D, in addition to asking them if they worry about falling and reducing the amount of medication that could contribute to a fall.
But the authors said vitamin supplementation and making changes in a senior's environment showed either no effect, or a mixed effect, in studies the task force reviewed.
The findings seem counterintuitive, which the authors acknowledge in the report, saying, "Theoretically, increasing physical activity could lead to more frequent falls and injuries, but the trial literature is too limited to confirm this idea."
Although some people in the studies reported "largely minor adverse effects" of exercise, such as muscle soreness, "injurious falls during exercise sessions were rare," they wrote.
Conversely, in one study in which people were given high doses of vitamin D, a "statistically significant" increase in falls was noted.
The panel said that its survey of the literature seems to suggest that group exercise is better than individual, and that it's better to do different types of exercise and not just one, and that the program should include strength or resistance exercises. It also said that these findings "should be interpreted with caution" and noted that the panel had not been able to analyze whether exercise had led to any cardiac problems or other serious health issues.
Other than when we're toddlers learning to walk, our greatest risk of falling occurs as we age. We lose strength as our muscle mass declines, a process that begins in middle age. After age 50, a sedentary person loses about 15 percent of his or her strength every decade. After age 70, the decline can accelerate up to 40 percent in a decade, according to a study published in the journal Sports Health.
Some of the decline is hormonal, but some is due to reduced physical activity, and that leads to muscle atrophy. To put it bluntly, as writer Amber Dance did in the Los Angeles Times earlier this year, "Laziness is a big cause of muscle loss."
Studies have shown that even previously inactive seniors can improve their strength and cardiovascular health with an exercise program. In one small study conducted in a nursing home, 10 people aged 90 to 96 participated in a resistance training program. The nine who completed the program improved their strength by 175 percent and improved their walking speed by 48 percent.
Dr. C.J. Rhodes recently wrote in The Reading Eagle Business Weekly about a senior who told her, "I've worked hard all my life. I deserve to rest now."
"I was at a loss for words. Who am I to deprive a senior citizen the well-deserved rest after a lifetime of hard work and physical labor?" Rhodes wrote. "And yet, there I was, trying to convince her that she needed to get up and exercise for an hour each day."
To help seniors begin to experience the physical and psychological benefits of exercise, family members can invite them to play golf or take a yoga class and participate with them, Jessica Bell wrote in The Houston Chronicle. They can also help seniors find group activities that they might enjoy, such as water aerobics or ballroom dancing. "Participation in exercise and other physical activities which are social in nature can improve a senior's sense of belonging," Bell wrote.
How do you convince an older person that he or she is at risk for falling and should find a way to start moving? Suggest that the person try this test: Stand on one foot for 10 seconds. If you have to grab onto something for support, you're at a risk for a fall, said Dr. Chris Sciamanna, a professor of medicine and public health sciences at Penn State College of Medicine, said in U.S. News & World Report.
While the task force report said exercise appears to be the most effective intervention for seniors at risk of falling, families can take other steps to help their older loved ones be safe. Among them: improve lighting in the home, make sure the senior has regular vision exams, eliminate throw rugs and other tripping hazards, and install safety bars and rails.
The American Occupational Therapy Association also recommends making sure that regularly used items are easily accessible and that families and caregivers arrange furniture so that there is plenty of room to maneuver and places that the senior can grab hold for balance if they begin to slip.
Also, dehydration is often associated with falls since the condition can cause dizziness, so make sure that the seniors in your life are getting enough fluids.