Older women who exercised the equivalent of 30 minutes a day, five times a week were up to one-third less likely to hurt themselves in a fall, according to an Australian study published today in JAMA Network Open.
Brisk walking and moderate or moderate-to-vigorous activity were also all associated with lower risk, the authors wrote.
The findings are encouraging, though not necessarily surprising, says Deborah Kado, MD, a geriatrician at Stanford Health and co-director of the Stanford Longevity Center, both in Palo Alto, California.
“It’s good to see data that suggests that getting more physical activity is associated with a lower risk of falling. Although we often take mobility — the ability to move safely from one place to another — for granted, when you lose it, you really lose your ability to be independent,” says Dr. Kado, who was not involved in the research.
3 Million Older Adults Go to the ER Each Year Because of a Fall
The Centers for Disease Control and Prevention estimates that about 1 out of 4 older U.S. adults fall each year, and about three million are treated in the ER, making it a major health concern.
Falls resulting in hip fracture are especially concerning — one meta-analysis suggests that about 3 in 10 older adults who break their hip die within the next year.
More Than 1 in 4 Participants Reported Falling Within the Past Year
The evidence on whether physical activity reduces fall risk has been inconsistent, and it’s also not clear how much exercise is required, according to the authors. To find out more about how physical activity impacted both injurious and non-injurious falls, researchers recruited over 10,000 women between the ages of 45 and 50 years old back in 1996. Over 7,000 participants, with an average age of 67 years old, completed follow up questionnaires between 2016 and 2019.
Participants self-reported their weekly amount of three types of physical activity:
- Walking briskly, for recreation or exercise or to get from place to place
- Moderate activity, such as social tennis, moderate intensity exercise classes, and recreational swimming
- Vigorous exercise that made them breathe harder or puff and pant, like aerobics, vigorous cycling, running, and swimming
The subjects were then placed into groups according to the number of minutes they logged: none, less than 150 minutes, 150 to 299 minutes, and 300 minutes or more.
Those amounts were chosen to align with the World Health Organization (WHO) guidelines on physical activity. “Any amount of physical activity is better than none, and more is better,” advises WHO. The organization recommends at least 150 to 300 minutes of moderate or vigorous aerobic activity per week.
Participants in the 2019 survey answered three questions about falls in the past year:
- Did they have a fall to the ground?
- Were they injured because of a fall?
- Did they seek medical attention for a fall-related injury?
About 2,000 women reported falling in the last 12 months, with about half leading to injury and half not.
Being Active for 2.5 Hours a Week Cut Fall Risk
After adjusting for factors that could influence risk, researchers found that doing 150 to 300 minutes of exercise per week reduced fall risk that didn’t cause injury by 26 percent and injurious falls by 30 percent. Exercising for more than 300 minutes — five hours — cut the risk by 34 percent for injury-free falls and 23 percent for falls that caused injury.
These findings support multiple exercise trials that show a link between physical activity and reduced fall risk, says Kado. “For example, tai chi has been shown to help older adults reduce their risk of falling,” she says.
Tai chi originated as an ancient martial arts practice in China, and the modern practice incorporates slow movements and physical poses with controlled breathing. A meta-analysis of 24 randomized controlled trials published in September 2023 found that tai chi “can effectively reduce the risk of falls in older adults” and improve balance and walking speed.
Walking Reduced Fall Risk by 17 Percent
Brisk walking lowered the risk by 17 percent compared with no exercise at all, according to the authors.
This supports earlier research that shows that walking can help prevent falls. A Japanese study of 90 older adults found that a walking intervention reduced the risk of falls more effectively than balance training.
The Good News: You Don’t Have to Exercise 3 Hours a Week to Get Health Benefits
Although the study didn’t find any reductions in fall risk in the group with less than 150 minutes a week of activity, that doesn’t mean that there’s no benefits to small chunks of movement, says Kado.
“The WHO guidelines are terrific, but to tell people they need to get 150 minutes of physical activity a week — I think that can be a deterrent for some people,” she says. In the real world, most people aren’t getting between 2.5 and 5 hours of exercise a week, says Kado.
But you don’t have to meet that threshold to make meaningful improvements in your health, she says. “The truth of the matter is, if you look at data, even the smallest amount of activity has benefits. And the biggest bang for the buck is at the early part of the curve. So basically, if you’re a couch potato and don’t do any physical activity, if you just increase a little bit, like get up and down and walk around the house every 15 minutes, that will decrease your risk of dying early,” says Kado.