Getting out and moving helps reduce the risk of falls in older people, study shows

Those little trips to the grocery store, the post office, and around the block can help protect people from falling, particularly when it comes to those over age 50 and people living alone.

A new study, published last month in the Journal of the American Geriatrics Society, interviewed 2,000 people between the ages of 50 to 80. On average, about 25% fell at least once between March 2020 and January 2021, and those who lived alone became significantly more afraid of falling, said Geoffrey Hoffman, an assistant professor at the University of Michigan School of Nursing and one of the study authors. More than a third said they were less active after the pandemic started, resulting in worse mobility, making them more likely to fall, he said.

“What we saw was that what might seem like slight changes in mobility can have big effects on falls and the risk of falling,” said Hoffman.

But it goes the other way, too, he said: Even little steps every day can make a positive difference.

“The more we can help those we know who might need a little push to get out and about, we think that’s worth doing as long as it can be done safely,” Hoffman said.

Being socially isolated might lead to more falls because there’s no one there to encourage movement, whether it’s a walk around the block or going to the grocery store. Less time “on your feet” time can lead to losing endurance and strength, as well as having cognitive and emotional implications, Hoffman said.

And once someone falls, they are more likely to fall again. In his survey, of those who fell, more than 30% fell two or three times.

“The worry is that, over time, there could be a disability epidemic,” Hoffman said. “Over the short term, we’ve seen evidence from when people go into the hospital, people cannot be on their feet, so they lose mobility, they stop doing regular activity. And this can have transient effects where they’ll come out of the hospital and have a real spike in their fall risk.”

Rebeca  Sternbach is an occupational therapist and a certified aging-at-home specialist based in Cherry Hill. Her 99-year-old grandmother fell last winter in an assisted living facility while walking out of her bathroom and suffered a pelvic fracture. Several of Sternbach’s friends also had grandparents fall within the past year — one broke her hip, and another broke his pelvis.

You might think that staying home would result in fewer falls, not more, Sternbach said, but the study and the pandemic itself really highlighted the importance of daily mobility and movement.

Even small things matter, like getting in and out of a car, getting up and down from sitting, and using the stairs, she said.

“Falls actually occur in the home 70% of the time, so even though people are going out less, it’s actually their own environments that are most unsafe, and they are spending the most time there,” Sternbach said.

Her clients weren’t as motivated to be active earlier in the pandemic, particularly without visits from family and friends, she said. Her grandmother was used to doing things on her own, but early on people were confined to their rooms, so they weren’t even walking to the dining room or meeting people in the hallways.

Jane Eleey is the executive director of Penn’s Village, a mostly volunteer organization based in Philadelphia that helps seniors stay in their homes. One of the group’s board members, a nurse, fell and broke her foot misjudging a step in her home after the pandemic began, she said.

“We know falls are happening for sure,” Eleey said, adding that she’d heard about incidents mainly through word-of-mouth.  She said Penn’s Village did a lot of check-in calling and food delivery, but visits and other at-home services were greatly reduced at that time.

Sternbach said a number of studies show that a fear of falling is the top predictor for falling again. It becomes a kind of cycle, she said: Once people fall, they are afraid to go out and fall again, so they become less mobile and therefore more likely to fall.

It’s good to have a plan in place, she said, making sure older people are getting to their medical appointments, having their eyes checked, and coming up with ways to get out of the house.

The COVID-19 vaccines and warmer weather have encouraged seniors to get out more. But as the winter months approach, the experts said, it’s important to keep moving and make efforts to improve safety in the home by improving lighting and looking for tripping hazards, like area rugs.

“I don’t think there is enough emphasis on the prevention,” said Sternbach. “As we go into the winter months … people need to be really looking at the home more, the little ways you can make your home safer, the little things that you could do to prevent falls in the first place.”