What older people can do to prevent falls

Research has shown that certain kinds of exercise programs can help to prevent falls in older people. These programs mainly include exercises to improve muscle strength and balance. They can be done in a group or one-to-one. The researchers looked at various forms of exercise, including

• walking and balance training,
• strength training,
• dancing or tai chi, and
• aerobic exercise.

But it's important to choose exercises that are suited to your own physical abilities.

Programs offered by a team of specialists from various fields (e.g. physical therapy and geriatric care) also help to prevent falls. Such mixed teams can recognize individual risks more easily and better adapt the measures to your personal needs.

Some medications can increase the risk of falls, either when taken alone or together with other drugs. They include

• sedatives or sleeping pills,
• diuretics and blood-pressure-lowering drugs,
• anti-epileptic drugs (anti-seizure drugs),
• opioids and
• some diabetes medications.

But you shouldn't stop taking any of these medications without consulting your doctor first. It is best to have regular doctors' appointments to talk about which medications you still need to take. It can help to put together a medication schedule to take along to your doctors' appointments. This is a list of all the medications you are on.

Current research suggests that older people in nursing homes and hospitals are less likely to have a fall if they take vitamin D. But only if they have low levels of vitamin D to start off with. Their vitamin D levels can be measured using a blood test.

Vitamin D is believed to strengthen muscles. It also helps the body to absorb more calcium and phosphate from the bowel when necessary. Having enough calcium in the body is important for normal bone metabolism and, as a result, bone stability. Vitamin D might be more effective when taken together with calcium.

Vitamin D and calcium supplements can have side effects. These mainly include the development of kidney stones. European and U.S. authorities recommend taking not more than between 1,000 and 1,300 mg of calcium in the form of dietary supplements a day.

It is also a good idea for different health professionals (such as doctors, nurses, physical therapists and occupational therapists) to jointly assess the individual risk of falling and then recommend preventive measures based on their findings. Research has found the following to be helpful:

• Treating vision problems and, for example, using a normal pair of glasses instead of bifocals.
• Cataract surgery (if you have cataracts).
• Occupational therapy.
• Treating foot problems.
• Using footwear with slip-resistant soles or shoe inserts.

Behavioral therapy can reduce the fear of falling.

Even though you can do a lot to prevent falls, not every fall can be avoided. So it's particularly important for older people (and people who have diseases such as osteoporosis and osteoarthritis) to know how they can stay mobile and strengthen their muscles, bones and joints.