Sallie Thoreson Colorado Department of Public Health and Environment
Rate per 100,000 100 120 20 40 60 80 0 2000 CoHID, 2000-2013 _______ 2001 2002 2003 2004 2005 Year 2006 2007 2008 2009 2010 2011 2012 2013
588 588 de deat aths 8,229 hospit itali alizat atio ions 18,90 900 E 0 Emergen gency cy Dept. visit visits
1 of 3 people 65+ fall every year. 1 of 5 falls causes a serious injury. The average hospital stay is over $30,000.
29-77% of community dwellers Can lead to spiraling effects ◦ Lack of confidence ◦ Limited physical activity ◦ Functional decline
Year 2000 12% 65+
Year 2050 20% 65+
Fall Prevention Public Health Recreation Community facilities
Aerobic Muscle strengthening Flexibility Older adults need all four. - tailored to address the changes of aging
Balance needs to We’ve got to get them out of their chairs! ◦ Reduce the base of support ◦ Move the center of gravity ◦ Reduce need for upper body support Gait training means you have to be moving You can start out with seated exercises
Exercise as a single intervention is an effective approach Include muscle strengthening and balance retraining Programs should include: Ch Challenge to to ba balance 50+ + hours rs On On-goin ing
Funders require it Agencies want proven results Implementers like “packaged” programs Older adults want programs that work Health insurers require proof
Group exercise program Focused on increasing functional ability (balance and physical function) One hour classes delivered by an instructor Standard program: 24 hrs over 12 weeks + homework Ideal class size 15 For older adults aged 60 and older, who can walk easily with or without assistive devices Evidence: 55% reduction of fall risk Similar program is Tai Chi for Arthritis
Main o outc tcom omes Additi tion onal o outc tcom omes Decreased falls Increased arterial flexibility Postural control Focused mental concentration Balance confidence Improved cognitive functioning Muscle strength Improved sleep quality Flexibility Pain relief Decreased fear of falling Stress reduction Lowered blood pressure Im Improved p physi ysical f functions Improved feeling of well- Increased knee flexion being and quality of life Ankle and knee joint strength Improved gait speed and stride length Ability to modify gait in response to changing demands
Group class addressing all aspects of falls prevention Exercise and progression of exercise is key Seven weekly 2-hour program sessions Led by healthcare professional or professionals within aging services Includes experts that are guest presenters (PT, OT, nurse, pharmacist, low vision expert, fireman/police officer) Evidence: 30% reduction in falls Similar program is Matter of Balance
At the end of Stepping At the end of Tai Chi On/Matter of Balance classes, the older classes, older adults adults want to know: want to know: ◦ Can I take this class ◦ What exercise classes can again? I take now? ◦ What other classes can I ◦ Where can I go to take now? exercise? Local park and rec departments can help!
Health Department Parks and Recreation Provide training in Train staff and contract evidence-based fall employees prevention programs Offer evidence-based fall prevention Provide guidelines for programs implementation To Toget ether er ‣ Partner to provide marketing ‣ Publish information on available programs ‣ Participate in data collection and evaluation ‣ Offer classes in new locations
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