Older persons are more likely than younger
people to need and use medications.
Unfortunately, medications are often either
unavailable or over-prescribed in this
population. Averse drug-related reactions,
polypharmacy, and confusion induced by
psychotropic medication are all associated
with an increased risk of falls and fallrelated
injuries. Health care strategies that
require regular and systematic review of
prescription and over-the counter medications
have been shown to decrease the
number of falls in older adult populations.
Because visual impairments, especially
poor contrast sensitivity and poor depth
perception, have been shown to be significant
risk factors for falling and fall-induced
injuries, regular visual examinations with
appropriate follow-up as necessary can be
beneficial in reducing falls in older adults.
Physical activity: The WHO Heidelberg
Guidelines for Physical Activity for Older
Persons recommend that virtually all older
persons should participate in physical
activity on a regular basis. There are well
established physiological, psychological,
and social benefits associated with participation
in physical activity. Furthermore,
regular physical activity is associated with a
significant decrease in risk for most noncommunicable
diseases. With respect to
falls prevention, regular physical activity
has been shown to prevent and/or lower an
older person’s risk for falling in community
and home settings.
For healthy older adults at low risk for
falls, engaging in a broad range of physical
activities on a regular basis is likely to be
sufficient to substantially reduce the risk of
falling.
In contrast, older adults at higher risk for
falls will benefit from engaging in structured
exercise programmes that systematically
target the risk factors amenable to
change and are progressed at a rate that is
determined by the individual’s capabilities
and previous experience with physical activity.
Older adults identified at the highest
risk for falls will benefit from an individually-
tailored exercise programme that is
embedded within a larger multifactorial
intervention approach. In these populations,
regular strength and balance exercises,
such as, Tai Chi programmes have
been shown to be effective in reducing the
risk of both non-injurious and injurious
falls. Additional research is necessary to
quantify the optimum type, frequency,
duration, and intensity of exercise needed
to produce the maximum benefit. Because
regular physical activity provides substantial
health-related benefits and it is cheap,
safe, and readily available, it is likely that
physical activity programmes will play a
major role in the prevention, treatment,
and management of falls in most countries
and cultures.