After 60, train balance and leg strength, and make the bathroom and stairs at home safer
- Moderate value
- Evidence A
- Buys life
- For: Elderly relative at home, Age 60+
- Costs a little
- Takes time daily
- Long-term effort
In plain words
Training balance 2 to 3 times a week, tai chi for example, cuts the number of falls among older people by about 23% and the number of people who fall by 15%. Making the home non-slip and adding grab bars cuts falls by about another 20%. Falls are the leading cause of injury death for people over 65 in China, and more than half of them happen at home.
- Cost
-
2 to 3 sessions a week, 30 minutes each of tai chi or balance training. Bathroom non-slip mats, grab bars and night lights cost a few dozen to a few hundred CNY. The hard part is keeping it up for the long term.
- What you get
-
Cochrane pooled 108 trials with 23,407 people. Exercise lowered the number of falls among older adults by 23% (rate ratio RaR 0.77; 95% CI 0.71 to 0.83, the plausible range). The number of people who fell dropped 15% (RR 0.85). Having someone come to the home to assess and modify it lowered the fall rate by about 20% (RR 0.81, 95% CI 0.68 to 0.97). Tai chi lowered the risk of falling by about 29% (RR 0.71). In China, falls are the leading cause of injury death among people over 65. Of the falls among older people monitored in 2018, 55.97% happened at home.
- Notes
-
This applies to people over 60 who live in their own homes, not in a nursing home. The studies above counted falls, not deaths. For an older person the path from a fall to a hip fracture to death is short. Not being able to see the ground also leads to more falls; for cataracts that affect vision, see §17.9 (cataract surgery). For older people pulled over while walking a dog, see §17.10 (walking a dog in old age). For whether the bones can withstand a fall, see §1.39 (bone density test).
- Evidence grade
- A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
- Sources
-
- Sherrington C 等 (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD012424.pub2
- Gillespie LD 等 (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007146.pub3
- Lu Z 等 (2021). Characteristics of Falls Among Older People — China, 2018. China CDC Weekly. https://doi.org/10.46234/ccdcw2021.013
Mentioned in
- Women over 65 should get one dual-energy X-ray bone density scan, and after menopause, women with risk factors for osteoporosis shouldn't wait until 65
- Don't spend big on supplements, herbal tonic pastes (膏方) or tonic products to “balance the body”
- If an older person falls or someone collapses, crouch down, call to them and call 120 (China's ambulance number); don't rush to pull them up. Walking away from a stranger is also legal in China, but if you stop, don't move them
- If an older person, two or three weeks to a few months after bumping their head, becomes unsteady on their feet, slow, sleepy or weak on one side, get a head CT
- If an older person's cataract already affects seeing the way, go to an eye doctor for an assessment and surgery; if both eyes have it, don't delay the second one too long
- If an older person walks a dog, hold the leash in the palm of the hand and don't wrap it around the hand, keep the leash short, and first train the dog not to lunge forward on the leash
Translated from the Chinese original. Original book, section 1, tip 13. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer