Citation

Freiberger E. J. Aging Phys. Act. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Human Kinetics Publishers)

DOI

10.1123/japa.2022-0101

PMID

35894987

Abstract

Due to the demographic aging, new events are coming more into the medical focus. The change from disease-oriented to function-related geriatric medicines under the umbrella of healthy aging (World Health Organization, 2015) puts sudden events as "falls or even injurious falls" right into the middle of geriatric prevention and rehabilitation activities (World Health Organization, 2008). Due to several global initiatives (American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention, 2001; Clemson et al., 2010; Guirguis-Blake et al., 2018; Medical Advisory Secretariat, 2008), it is now widely accepted that 28%-38% of the population over 65 years fall at least once annually, with a high percentage falling several times. As age increases, the rates of falls tend to increase as well, suggesting an age-related increase in fall risk rising up to nearly 50% in the age group 80 years and above. Falls are posing a burden to the public health care system and to older persons themselves as in up to 30% of falls cause mild-to-severe injuries, and in some cases even cause death. Injuries after a fall event can lead to prolonged use of health care service including high health care costs (Montero-Odasso et al., 2021). The estimated annual costs for fall-related medical services range from $31.3 billion dollars to $49.5 billion dollars in the United States (Haddad et al., 2019; Houry et al., 2016).

Therefore, falls are a serious threat to older persons for healthy aging, as falls and especially fall-related injuries are associated with a higher risk of onset of disability, reduced mobility, loss of independence, and even higher risk of mortality (Scuffham et al., 2003; Todd & Skelton, 2004). Falls prevention has become in many countries a mandatory goal by implementing national strategies to reduce falls in the older population (Campbell & Robertson, 2010; Hill et al., 2018; Rose et al., 2007).

Many risk factors for falls have been identified and can be categorized into intrinsic, behavioral, and extrinsic factors (Rubenstein, 2006; Todd & Skelton, 2004). The most important intrinsic risk factors are for example, a fall in the last 12 months, gait and balance disorder, and low strength (all with an odds ratio between 2 and 3; Deandrea et al., 2010; Todd & Skelton, 2004). Behavioral risk factors are fall-related psychological concerns (FrPC) including fear of falling, as well as the other side of the coin, self-efficacy. Environmental risk factors are, for example, loose carpets, low lightening, or missing handrails (Todd & Skelton, 2004).

Preventive interventions with the most positive reduction in fall rate have been identified and include multicomponent exercise programs (Hopewell et al., 2018; Sherrington et al., 2019). Exercise programs including challenging balance exercise and progressive strength training have shown very effective results as well as Tai Chi exercise interventions (Nyman, 2020; Sherrington et al., 2019).

Despite the evidence of effective intervention, major challenges and barriers exist to a worldwide reduction in fall rates on national and international levels...

Language: en