Are You Inactive? If Yes, Prepare To Fall!

Around a third of people aged 65 and over and half of those aged 80 and over experience a fall each year.

As a result, there are over 250,000 emergency admissions of elders to hospitals for falls every year. This is unfortunate, since many falls and fractures can be avoided by simple exercises that improve people's strength and balance.

So why aren't elders exercising to prevent falls? According to a new report, 40% of elders over age 70 underestimate the importance strength and balance in warding off falls. In fact, the opposite seems to be occurring. Reports suggest that the over-65s are the most sedentary or inactive age group, with many spending on average 10 hours or more each day sitting or lying down. This is sad, because inactivity or immobility is one of the biggest risk factors leading to falls.

Causes of Inactivity

The human body is designed for movement. Without an active lifestyle, our bodies and minds deteriorate. There are several health conditions that can interfere with achieving safe mobility.

These include:

• Emotional disorders (depression, fear of falling or getting hurt, dementias, apathy and lack of motivation, etc.).
• Musculoskeletal disorders (arthritis, osteoporosis, foot problems, deconditioning of muscles after acute illness, etc.).
• Neurological disorders (stroke, Parkinson disease, numbness and pain of hands/legs, spinal cord injury, etc.).
• Cardiovascular disease (heart failure, frequent angina, hardening of the arteries, etc.).
• Sensory factors (impaired vision and/or hearing).
• Drug side effects (dizziness, confusion, balance loss, etc.).
• Environmental causes (inadequate/inappropriate devices for mobility, lack of caregivers to provide support, home safety hazards, such as lack of handrails on stairs or grab bars around a toilet, etc.).

Individuals with one or more of the above conditions are at great risk for inactivity or immobility.

This brings many potential health risks:

Cardiovascular

• The heart, like any muscle in our body, decreases in size without regular activity. This can lead to a decrease in the ability of the heart to pump blood and circulation problems. This can result in low blood pressure and even heart attacks.
• Muscle contraction helps blood circulate. Lack of muscle use slows down circulation, which can cause blood clots.
• Reduced blood circulation may also lead to fluid type swelling (edema) in the lower legs during long periods of inactivity.

Respiratory

• Chest muscles become weakened. This results in less lung expansion and shallow breathing. The major risk here is pneumonia, as the ability to cough is weakened and secretions can build up in the lungs.

Musculoskeletal

• Muscles and bones become stronger when they are being used regularly. Even small periods of inactivity will result in muscle loss and decrease in bone strength (the risk of osteoporosis). Muscle weakness also affects balance; leg muscles are the first to become weak. This increases a person's risk of falling.

Neurological

• Lack of mobility can result in coordination and balance problems, which increases the risk of falling.

Cognitive

• Long periods of immobility can result in several psychological issues such as depression, anxiety, anger, and confusion.

Nutrition

• Immobility results in fewer calories being burned and poor appetite. As a result, dehydration and malnutrition/weight loss can occur.

Urinary

• Physical activity and gravity help to drain urine from the kidneys to the bladder. Inactivity can cause a build-up in urine in the kidneys. This increases the risk of kidney stones and urinary tract infection.

Inactivity Solutions

Inactivity can trigger a series of subsequent diseases and problems that can produce further pain, disability, impaired quality of life, and fall risk (the ability to safely navigate a wide variety of environments requires balance, agility, and flexibility). So, what can elders and/or their caregivers do to reduce the effects of increased inactivity?

Keep Moving

• Improving mobility should be the goal of all elders. Although, some elders may be reluctant to exercise, it's important that they do whatever they can, whenever they can. Even small improvements in mobility can lessen the severity of complications, improve the person's well-being, and decrease the risk of falls.
• It's recommended that individuals participate in some form of regular endurance exercise (such as walking and cycling) to increase their heart function and circulation. However, aerobic exercises by themselves do little to preserve muscle strength, which requires strength or weight training. To maintain good health, at least 30 minutes of exercise five days per week is needed.

How to Get Started

• If a person has rarely exercised or it's been a long while since participating in regular exercise, check with the family doctor. First to make sure that it's all right to exercise, and second, to evaluate what types and duration of exercises are best based on individual health conditions. Physical therapists and certified exercise specialists can also conduct a proper exercise assessment.
• Whatever exercise program individuals choose, it is always best to ease into the program, just to see how the person's body (muscles, joints, and balance) are reacting to the training.
• Aerobic versus weight training exercises, which to choose? To avoid injury, new exercisers should probably start with aerobic exercises, since weight training (using free weights, such as dumbbells/ barbells) requires some balance and coordination. Weight training with an experienced, qualified trainer is advised. This helps ensure that appropriate exercises (with the right amount of weight and correct form) are being used.
• Lastly, listen to your body. After exercise, any muscle soreness typically lasts 24 to 48 hours; anything beyond that is a sign that you are doing too much.

Author: Dr. Rein Tideiksaar Rein Tideiksaar Ph.D., PA-C is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant.