In the news: Specific Exercise & Diet Can Help Prevent Falls as We Age

Tai Chi for Preventing Falls in Mature Adults

As we grow older, we face a greater risk of falling – a common cause of injury in the elderly. Maintaining our balance is crucial to preventing these potentially disabling tumbles. But how do we preserve good balance? Exercise is a key component, according to a recent review of studies looking at the impact of exercise in preventing falls (1). But that brings up a second question: What kind of exercise programs are most effective at helping to achieve good balance?

A team of researchers from Oregon recently took on that question, and the results of their study were published in the September issue of the journal JAMA Internal Medicine (2). They report that tai chi (also called tai ji quan) is more effective than conventional exercise approaches at preventing falls in high-risk, older people.

The study included 670 independently living adults, 70-years or older, who had fallen in the preceding year or had impaired mobility. Participants were randomly assigned to one of three 60-minute, twice-weekly exercise classes: 1) tai chi; 2) stretching exercises (considered the control group); or 3) exercises that integrated balance, aerobics, strength and flexibility.

At the end of 24 weeks, the tai chi intervention reduced falls by 58% compared with the stretching exercise, and by 31% compared with the conventional integrated exercises.
 
There are many advantages to tai chi: It’s slow and gentle, yet improves both upper- and lower-body muscle strength, balance, flexibility and, to a lesser degree, aerobic conditioning. Remember, too, that tai chi can be combined with other exercises you may do such as swimming, stationary biking, or work with hand weights and resistance bands.

What Else Can You Do to Help Prevent Falls?

From a nutrition standpoint, making sure you are not vitamin D deficient or consuming too little protein are important. Poor vitamin D levels have been linked to increased risk of falling in people over 70. First, vitamin D insufficiency can lead to reduced bone mass density which puts people at greater risk for fractures when they fall. In addition, vitamin D deficiency increases the chances for muscle weakness. Vitamin D is needed to transport calcium into muscle cells, enabling muscles to contract. Vitamin D also plays a regulating role in building and repairing muscle fibers. The daily recommended intake for vitamin D is 800 IU for those 70 and older.

With advancing age, people tend to lose muscle mass as well as muscle strength (called sarcopenia), both of which have been linked to falls and fractures (3).

Studies have shown that consuming about 20-30 g of protein (about 3-4 oz. ounces of protein-rich foods) 3 times daily promotes muscle growth in both young and old alike. Include protein foods that are good sources of leucine (e.g. cheese, beef, chicken, pork, fish, nuts and beans), as this amino acid can stimulate protein synthesis in muscles.  

Finally, take stock of and address other factors that can lead to poor balance and falls. Examples include: inner eye problems, hearing loss, vision changes or decline, pain, foot problems, arthritis of the knee, low blood pressure or other causes of dizziness, and some medications (e.g. blood pressure-lowering, sleep inducing, anti-convulsant, and antidepressant drugs).  

So, to move with better balance, comfort and confidence: Do appropriate exercises regularly; Consume sufficient protein and vitamin D daily; and Identify and find solutions for other related factors.

References

1. Sherrington C, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 51:1749–1757, 2017.
2. Fuzhong Li, et al. Effectiveness of a therapeutic tai ji quan intervention vs a multimodal exercise intervention to prevent falls among older adults at high risk of falling: A randomized clinical trial. JAMA Intern Med. Published online September 10, 2018.
3. Clynes MA, et al. Definitions of sarcopenia: Associations with previous falls and fracture in a population sample. Calcified Tissue International. 97 (5), 2015.