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TUESDAY, April
17, 2018 (HealthDay News) -- With aging often comes worry about falls and the
bone fractures they cause. Now, a panel of U.S. experts has new advice on what
helps and what doesn't when it comes to staying upright.
For starters, get
off the sofa. And don't rely on vitamin D to keep you from falling.
In a change from
its 2012 recommendations, the U.S. Preventive Services Task Force (USPSTF) is
recommending against vitamin D supplements for "community-dwelling"
(those living at home) adults over 65 for preventing falls. A review of
existing research showed insufficient evidence to recommend a supplement.
So what does help
people prevent falls? Exercise, the task force said.
"The
strongest evidence is for exercise. If you're at risk of falling, you should
think about exercise," said the task force's vice chair, Dr. Alex Krist,
from Virginia Commonwealth University in Richmond. He added that about 20
percent of Americans over 65 have a fall each year.
The review and
recommendations were published April 17 in the Journal of the American Medical
Association.
An author of an
editorial that accompanies the new recommendations agreed exercise can be
beneficial.
"These
recommendations are suggesting that we need to go beyond popping pills in order
to have a major impact in preventing falls and fractures," said Dr. JoAnn
Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston.
"Regular
exercise can reduce falls with injury and it can also reduce heart disease,
stroke, type 2 diabetes, dementia and some forms of cancer," Manson said.
"Physical
activity is as close to a magic bullet as there is. And it doesn't take that
much -- just 30 or 40 minutes three times a week can make a difference,"
she added.
Both Krist and
Manson advocated for a variety of exercises. They said for someone healthy
enough, the general physical activity guidelines of 30 minutes of aerobic
activity most days of the week, and strength training twice a week, are a good
place to start.
But not everyone
over 65 can achieve that goal. Krist said to start with your doctor to get a
better idea of what exercise might be right for you. For some people, the
supervision that comes with physical therapy is helpful. For others, a class
such as tai chi might work best. And for others, more vigorous activity may be
fine.
The USPSTF is a
volunteer panel of national experts. They develop recommendations for disease
and injury prevention after a rigorous review of scientific evidence.
The new
recommendations suggest that doctors should selectively offer multifaceted
interventions to seniors at a high risk of falling.
These might
include: group or individual exercise, psychological therapy, nutrition
therapy, education, medication management, urinary incontinence management,
environmental modification, and physical or occupational therapy. Social
services and referral to specialists such as an ophthalmologist, neurologist or
cardiologist are other options.
Referrals can be
important because some issues may be reversible. For example, sometimes
addressing problems with vision can aid in fall prevention.
"Often,
older individuals assume vision loss is inevitable and a normal part of the
aging process. Very often, though, problems such as cataracts or glaucoma are
treatable," Manson said.
"Falling is
a major concern for older adults, and some are afraid to go outdoors because
they're afraid of falling," she said. That leads to a double whammy as
they stay inside, their muscles may atrophy, they don't get any sunlight and
may develop a vitamin D deficiency, and they're losing out on important social
interactions, Manson explained.
"I recommend
at least doing strength training inside the home, or getting a treadmill to use
at home. Or find a friend or family member that can go out for a walk, or start
a walking club in your neighborhood," she suggested.
The task force
also recommended against daily supplementation of 400 international units of
vitamin D and 1,000 milligrams (mg) or less of calcium to prevent fractures in
postmenopausal women living at home.
It wasn't clear,
however, if higher doses might provide a benefit, according to the new USPSTF
recommendations. There also wasn't enough evidence for the task force to
determine whether vitamin D and calcium supplements could help men or
premenopausal women avoid fractures.
More information
Learn more about
preventing falls from the U.S. National Institute on Aging.
SOURCES: Alex
Krist, M.D., M.P.H., U.S. Preventive Service Task Force vice chair, and
professor, family medicine, Virginia Commonwealth University, Richmond; JoAnn
Manson, M.D., Dr.P.H., professor, medicine, Harvard School of Medicine, and
chief, preventive medicine, Brigham and Women's Hospital, Boston; April 17,
2018, Journal of the American Medical Association
Last
Updated: Apr 17, 2018
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2018 HealthDay. All rights reserved.
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