Aging Gracefully – A Balancing Act
By Healthways SilverSneakers® Fitness Program
Nancy Kimm probably never imagined that she would have to crawl through a window to get inside her house, but when the spry 69-year-old and her husband accidentally locked themselves out of their home, she sprang into action, going through a window that had been left partially open. “We got me up off the ground and through the kitchen window; I had to climb over the sink and then jump down onto the floor,” she recalls. “My husband kept telling me don’t break a leg, but all I could think about was how glad I was that I had done the dishes,” she jokingly adds. Kimm attributes the balance and flexibility it took to gain access to her home to her regular participation in a popular fitness program that is designed exclusively for older adults.
Kimm is a true testament to the fact that engaging in activity that increases muscle strength and improves conditioning enhances your overall ability to maintain balance while minimizing the likelihood and severity of a fall. Since beginning her group exercise routine more than three years ago —which includes a muscular strength and range of movement class at least two times a week—she has seen positive results in an area of crucial importance to older adults. “I not only feel the difference in my balance, but I can see improved balance in other class members,” she states.
Kimm and her husband are certainly on the right track in taking an active role in participating in activities that support the need to maintain good balance. Phoenix physician Dr. Kenneth Levy, board certified in both internal and geriatric medicine, can attest to the long-term benefits of balance, which is not only a basic brain stem function with which we’re all wired, but something we all need to live. “Without balance, the risk of falls and injuries related to falls is very real and so is the potential loss of peoples’ independence,” he explains. “For older adults, balance is important for their quality of life, the degree of independence they possess, and how good they feel. Essentially, for this group it’s all about their independence and quality of life.”
Older adults like Kimm are improving their chances for continued independence by protecting themselves from falls, the leading cause of injury-related deaths among older adults. According to the Centers for Disease Control and Prevention (CDC), each year more than a third of older adults age 65 and older experience a fall. In 2005, emergency trauma centers treated more than 1.5 million older adults for falls with more than 15,000 fatalities resulting from fall-related injuries. A 2005 CDC study revealed that seniors 85 and older experienced four to five times the number of falls as compared to older adults ranging in age from 65 to 74. This same study revealed that nearly 85 percent of deaths resulting from falls in 2004 were among individuals 75 years old and older.
“A big risk of a fall is a fracture,” states Levy. “Obviously, some fractures are more severe than others—such as a fracture of the hip, knee cap, wrist or ankle—and can impact the confidence level of older adults. When this happens, it can cause an older adult to do less and ultimately lead to a level of disability that can prevent them from turning a key in the door, walking from room to room, opening a jar or reaching for something on a shelf.” Balance however, is a function that is vital to keeping older adults steady on their feet and in good condition to recover quickly in the event of a fall.
Use it or lose it
While not all falls result in severe physical injuries, any fall or even a near fall can have serious psychological implications, resulting in total inactivity because the individual may develop a fear of falling. This in turn can contribute to a decline in health and greater risk of future falls as the muscles begin to atrophy. A fall poses even greater risk if it is due to a lack of strength and bone density, both of which are needed to maintain balance. Two age-related forms of deterioration contribute to the loss of strength and function in the muscles and bones of older adults. Sarcopenia (disuse atrophy) is the deterioration of muscle mass, and osteoporosis is the deterioration of bone density. After suffering a fall, eventually returning to a regular physical activity routine is important for older adults who are striving to maintain overall health and independence as it helps to strengthen muscles and bone.
The point at which balance starts to diminish varies from person to person and depends in great part on an individual’s motor, joint and nerve functions along with other health-related factors. “Some people at the age of 90 are running up stairs while others at the age of 70 are having nerve function issues or seeing their joint functions decrease,” explains Levy. He adds, “Peripheral neuropathy (damage to the central nervous system) also plays a major role in the aging process and diminishing balance.”
Considering one’s balance can decrease over time, particularly if a sedentary lifestyle is the norm, there are steps older adults can take to maintain or even improve their balance. Physical activity plays an important role in maintaining functions such as balance, strength and flexibility, which is why Levy stresses the need to “use it or lose it … but don’t injure yourself.” He adds, “It’s very important to talk to your doctor before starting an exercise routine.” In addition, Levy says, “You lose balance a lot faster when you’re in your 40s and 50s … and especially after the age of 50. We also lose strength as we get older and nerve function also starts to slow down with age.”
Levy advises performing exercises that increase muscle strength as well as strengthening the core and participating in activities that help maintain range of motion and joints. “A good goal to strive for is strength training exercises every other day, and some form of cardiovascular activity each day.” He adds, “It helps to mix up the cardio routine with walking, biking, and other activities,” Incorporating cortical exercises—dance, Tai Chi and yoga—into a physical activity regimen is also something Levy encourages. He strongly advises older adults to avoid toxins such as alcohol and cigarettes, and treat chronic conditions such as arthritis, heart disease, diabetes and high blood pressure.
Get Up and Get Moving!
Aware of the reality that with age comes the probability of falls, Kimm has no doubt that her participation in exercise classes is the ideal venue to help her improve in areas that are particularly important to her as an older adult. “I wanted to build muscle and the class has helped me do that,” shares Kimm. “In the process, I’ve also improved my flexibility and strength because I get an overall workout.” With both balance and flexibility ranking high on the list of attributes important to the physical well-being of older adults as they age, by maintaining these functions they are in fact ensuring fuller movement, reducing joint pain and decreasing their risk of injury due to falls—all of which help them to perform everyday tasks and remain in their homes.
Older adults like Kimm are taking to heart instruction to get up and get moving, and they are recognizing the benefits of regular physical activity. With activities that improve their balance and flexibility, not to mention strengthening their heart and lungs with regular aerobic activity, this group is getting fit, making friends and having fun in the process. “You can see from week to week the improvement in people in our class,” Kimm says. “I see how our posture has improved, and our confidence is better, too. People are getting out there and doing things they’ve always wanted to do but thought they couldn’t because of their age. Members are infused with happiness and confidence because of what they’ve accomplished in classes. It’s awesome.”
Staying steady on your feet and preventing falls
While physical activity is one of the most important health improvement steps older adults can take to maintain physical and mental health and quality of life, here are some basic measures that can be implemented to ensure that they remain steady on their feet and safe in and around the home.
Clear the way. Remove obstacles that could potentially result in a fall such as loose rugs, telephone wires, electric cords and cables.
Wear the proper footwear. Be sure shoes have the correct fit, support and traction. If ice and snow are common to the area, good traction is definitely a must.
Remove snow and ice. Speaking of snow and ice, have walkways and steps cleared of snow and treated for ice build-up.
Light the way. Something as simple as examining and improving the lighting quality in the home can go a long way in avoiding a fall.
See your way clear. Make sure regular eye exams are on your list of things to do at least once a year.
Checks and balances. Talk to your doctor about undergoing the proper screenings to check your balance as often as recommended, and be sure to follow their guidance on improving in this area.
Evaluate medications. Talk to your doctor and pharmacist about medications, ensuring that they aren’t leaving you vulnerable to side effects or reactions that may cause dizziness or an imbalance.
Accessorize. Have slip-resistant flooring and accessories like grab bars and rails installed in bathrooms and other areas of the home as needed.
In addition to this list of fall-prevention measures, check with the local Area Agency on Aging to learn about resources that offer services to help older adults fall-proof their homes. Additional information about fall prevention in the home is available at the website for the National Council on Aging at www.ncoa.org.
For older adults needing to add physical activity to their daily routine to improve balance, flexibility and other functions, contact your health plan provider to see if you are eligible for a free or discounted fitness program. You can also check with local community centers or parks and recreation offices to see if they offer programming geared toward exercise or fitness classes for active adults. Remember, the effort you put into your health now will go a long way in helping you find the right balance between aging gracefully and ensuring the quality of life you deserve.