Proven ways to prevent falls

QUESTION

I’m 66 and generally healthy, but have had a couple of nasty falls in the last two years. The last one was a few weeks ago; I tripped while walking down the road and ended up with a broken wrist. I’m a bit worried about falling again. Is there anything I can do to help prevent it?

H.H., via email

ANSWER

Nearly a third of people over the age of 65 and more than half of people over 80 have a fall one or more times a year.1 More than 30 percent of these falls need medical attention, and around 5 to 7 percent result in a fracture.2

As well as causing injuries, suffering a fall can lead to a fear of falling, which has the knock-on effect of causing the person to restrict their activities, meaning they can become less physically fit. This in turn increases the risk of having a fall in the future.1

Fortunately, there are a number of ways to slash your risk of a fall—and your fear of falling too—many of which involve improving your balance and coordination. 

Besides common-sense strategies such as avoiding using your phone while walking, keeping your home clutter-free and getting your eyes checked, here are some evidence-based ways to cut your chances of taking a tumble.

Try balance-based exercise

Exercise is known to reduce the risk of falls. The most effective kind appears to be exercise that involves balance training and is done for more than three hours a week. In one review of 88 trials involving nearly 20,000 people, this type of exercise reduced the risk of falls by 39 percent.3 Speak to your doctor about virtual or in-person fall prevention exercise programs that are suited to you, or search online. Your doctor may also be able to refer you to a physiotherapist, who can devise a targeted training program tailored to your needs.

Get gardening 

Fewer gardeners—classed as those who spend at least an hour a week gardening—experienced a fall in the past two years than non-gardeners in one study. Gardeners also had better balance and gait speed as well as fewer chronic conditions and functional limitations.4 

Try tai chi  

This ancient Chinese mind-body technique, which combines deep breathing and relaxation with gentle movements, appears to be useful for preventing falls. In one study of people 70 and older, practicing tai chi three times a week for six months improved balance and physical performance and reduced the number of falls as well as the fear of falling.5

Another trial compared a specific balance-oriented tai chi program, “Tai Ji Quan: Moving for Better Balance,” against a “multimodal” exercise program (a mix of aerobic conditioning and strength, balance and flexibility training) and a program of stretching exercises alone. Those in the tai chi group were significantly less likely to have serious injurious falls.6 

Look online for tai chi classes near you, if restrictions allow, or for a virtual course. 

Take vitamin D 

There’s conflicting evidence on whether vitamin D can help prevent falls. But a recent pooled analysis of 47 randomized controlled trials (considered the gold standard for assessing whether something works or not) involving more than 58,000 people found that taking vitamin D supplements, especially D3, significantly reduces the incidence of falls. And taking calcium alongside vitamin D may reduce the risk of not just falls, but fractures too.7

Suggested dosage: at least 800 IU/day vitamin D3 plus 1,000 mg/day calcium  

Dance 

Dancing, such as folk or ballroom dancing, may help reduce the risk of falls. In one study, people who took part in some kind of dance activity—defined as anything involving coordinated upright movements emphasizing dynamic balance and structured through music or an inner rhythm (e.g. breathing) with social interaction and distinctive instructions—had a 37 percent reduced risk of falling.8

There are even dance classes specifically designed for fall prevention, such as Dance to Health (www.dancetohealth.org), which offers weekly online dance sessions for over-55s in the UK, and Ballroom Basics for Balance in the US (www.ballroombasicsforbalance.org).

Watch your weight 

Obese older adults are more likely to suffer a fall, or multiple falls, compared to their non-obese counterparts.10 If you’re not already a healthy weight, focus on healthy eating (see the Special Report in the April 2021 issue of WDDTY) and exercise to get you there. 

Consider NeuroMovement

According to WDDTY contributor and movement expert Anat Baniel, founder of the science-based Anat Baniel Method® NeuroMovement®, one of the reasons older adults begin falling is because they are no longer able to quickly and clearly feel sensations coming from the soles of their feet. Without this information, the brain can’t make adjustments to the body to ensure it maintains balance. The good news is that this common deterioration is reversible with the right training, says Anat. See the WDDTY August 2016 issue for three NeuroMovement lessons you can do at home to provide your brain with the conditions and information it needs to improve your balance skills and begin reversing any deterioration you may have. And visit www.anatbanielmethod.com/wddty  for one month’s free access to Anat’s online program NeuroMovement & Your Busy Life.

Try whole-body vibration 

Whole-body vibration exercise, where you stand, sit or lie on a machine with a vibrating platform, has been found to reduce the risk of falls, probably because it improves muscle strength and dynamic balance.13 You can often find these machines (such as Power Plate machines) in gyms, where an instructor can take you through how to use them, or personal machines for at-home use are available to buy online.

Wear slippers 

Many of us wear socks or go barefoot at home, but both are known to increase the risk of falls in older people.9 Simply investing in some well-fitting slippers with a firm, slip-resistant sole could go a long way in helping to stop you from falling. Similarly, choose nonslip outdoor shoes, and avoid high heels. 

Go for yoga

Yoga, which typically involves a combination of physical postures, breathing exercises and concentration/meditation, can improve balance and mobility in older people.11

In one preliminary study, a one-hour yoga class twice a week for three months resulted in improved ability to rise from a chair, increased step length, weight loss and reduced fear of falling—all of which suggest yoga may be a useful fall prevention strategy.12 

Check your meds

Several types of drugs are associated with a significant risk of falls, including sedatives and hypnotics, antidepressants, benzodiazepines, neuroleptics, antipsychotics and nonsteroidal anti-inflammatory drugs (NSAIDs).14 If you’re taking any medication, schedule a review with your doctor to assess the risks and see whether alternatives or a dose adjustment might be needed.