Prescription for exercise could be the key to preventing falls

Clinicians can play a key role in helping older adults stay active, healthy and socially engaged  

It may be that the best prescription a health care provider can write to their older adult patients won’t include a trip to the pharmacy but take people to the sidewalk, gym or yoga studio.

“We know from the research that exercise appropriate to the age and ability of the individual does more to reduce the incidence of injuries, including falls, in older adults than any prescription can,” says Dr. Jane Thornton MD, PhD, Resident Physician and former Olympic rower. “While it is clear that the old adage ‘use it or lose it’ is true, it’s also never too late to start. Any one of us can increase muscle size and function with regular, appropriate exercise and at the same time improve our balance and agility.”

She shared her experiences and research findings as a panellist at Ryerson University’s National Institute on Ageing Conference (NIA) held in Toronto last November. (More information on the NIA can be found here.) ONF staff facilitated and led sessions at the conference.

The research strongly indicates that preventing falls helps maintain functional independence by reducing the incidence of traumatic brain injury and broken bones, either of which increase the risk of mortality in older adults.

Sue Lantz, NIA Conference Chair and former ONF CEO agrees there is a significant role for clinicians to support and even prescribe more physical exercise and active living options for older adults based on the health and risks and conditions of each individual. “This approach directly addresses two of the four pillars within the National Seniors Strategy for healthy aging. The first two pillars are Independent, Productive and Engaged Citizens, and Healthy and Active Lives,” says Sue. “Advancing the other two pillars, Care Closer to Home, and Support for Caregivers, can be significantly enhanced – or even determined – by how well the first two pillars are achieved.”

Dr. Thornton gained a deeper understanding of the connections between physical activity, injury prevention, health and independent living while studying preventative medicine in Europe for a year. There she found that physicians achieved excellent results with older adult patients by asking questions and directing them to resources that included exercise and engaging them socially.

“I found European health care organizations were more likely to have databases and information that specifically targeted the needs of older adults on everything from chronic conditions such as diabetes and heart disease to independent living and physical activity,” she says. “People were encouraged to find a tai chi or yoga group close to their home or a community support group for those who were determined to continue living independently.”

Canada and Ontario are a long way from the prescription for exercise route but the Canadian Medical Association has identified the importance of physical exercise in maintaining health through the “Demand a Plan” program. Dr. Thornton has shared her perspectives on Demand a Plan and Healthy Debate blogs .

“Falls and other injuries in older adults can happen due to a lack of balance, trying to do things more quickly than necessary or as a result of too much, too little or a reaction to medication,” she says.

Most older adults visit a clinician – usually a family physician – at least once a year. “This is a great opportunity for clinicians to begin a conversation about physical activity and encourage their patients to find an approach they can enjoy,” says Dr. Thornton. “I like the strategy of asking someone how they might want to keep active – what sort of thing would they enjoy doing that could also help them stay out of hospital and live independently longer. In my experience they usually feel strongly about maintaining their independence as long as possible. Why should a preventable fall take that away from them?”

Related resources: Loop is an online platform that brings together practitioners, caregivers, researchers, older adult groups and policy planners working for the health and care of older adults. Visit www.fallsloop.com to find information or join the conversation to improve the implementation of evidence-informed fall prevention practices. More information on exercise and falls prevention can also be found here.