Task Force Recommends Exercise to Prevent Falls in Older Adults
Comments Welcome Through Jan. 8
Dec. 14, 2023, News Staff —Family physicians are encouraged to comment on drafts of an updated recommendation and evidence review on preventing falls in older people by Jan. 8, 2024.
The draft recommends, at a “B” level, offering exercise interventions to prevent falls in community-dwelling adults age 65 years or older who are at increased risk for falls.
It also recommends, at a C level, that clinicians individualize the decision to offer multifactorial interventions to prevent falls in this population. Clinicians should talk with their patients and take into account factors such as a history of and reasons behind previous falls, comorbidities, and the patient’s values and preferences.
“Falls are the leading cause of injuries in older adults and can even lead to death,” Li Li, M.D., Ph.D., M.P.H., a member of the task force who also serves as the Walter M. Seward Professor and chair of the Department of Family Medicine at the University of Virginia School of Medicine in Charlottesville, and director of population health at UVA Health, said in a USPSTF bulletin. “The good news is that exercise can reduce the risk of falls in adults 65 and older, resulting in improved physical well-being of older adults.”
The update is mostly consistent with the task force’s 2018 statement. However, the previous statement recommended against vitamin D supplementation to prevent falls in community-dwelling adults age 65 years or older, which is not addressed in the new draft and will be covered in a separate recommendation.
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Consider Individual Patient Factors, Interventions
When determining which patients are more likely to fall, the task force said that clinicians should consider factors such as age and history of falling. Other factors include
- alcohol or drug use,
- certain physical aspects of a person’s home or neighborhood,
- hazards at home or work,
- medications that may increase fall risk and
- sensory problems.
The task force also said multifactorial interventions are useful in helping clinicians assess and address individual patients’ fall risks. These interventions may include, among others,
- cognitive behavioral therapy,
- education,
- environmental modification,
- medication management,
- referral to other specialists,
- social or community services and
- urinary incontinence management.
“Additional interventions beyond exercise can help some older adults further reduce their risk of falling,” noted James Stevermer, M.D., M.S.P.H., another task force member who also serves as vice chair for clinical affairs and a professor in the Department of Family and Community Medicine at the University of Missouri School of Medicine in Columbia. “Clinicians can talk to patients about their personal circumstances, such as history of past falls and values and preferences, to help determine who may or may not benefit.”
Learn More With AAFP Resources
The draft recommendation features a new summary that clinicians can share with patients with links to CDC resources on fall prevention and the Stopping Elderly Accidents, Deaths and Injuries initiative, and guidance from the National Institute on Aging.
AAFP members also have access to
- the American Family Physician by Topic Geriatric Care collection, which addresses preventing falls and fractures as well as gait/balance disorders and mobility assistance devices;
- the AAFP’s Geriatric Medicine CME collection with 15 activities that offer the latest knowledge and tools to enhance patient care, with more coming soon; and
- articles on familydoctor.org, the Academy’s patient-centered website, that address reducing fall risk, the benefits of exercise for older adults and other healthy habits that can reduce falls.