Poll: COVID-19 may have upped fall risk for older adults

"As life gets closer to normal, especially for the large percentage of older adults who are fully vaccinated against COVID-19, health care providers and loved ones should encourage more interactions that involve safe physical activity," says Preeti Malani.(Credit: Jair Ferreira Belafacce/Getty Images)

The COVID-19 pandemic may have increased older adults’ risk of falling and injuring themselves, due to changes in physical activity, conditioning, and mobility, a new national poll suggests.

More than a third of people between the ages of 50 and 80 report their physical activity declined in the pandemic’s first 10 months, and more than a quarter say they’re in worse physical condition now than before the pandemic, according to the new findings from the University of Michigan’s National Poll on Healthy Aging. Many of these adults also reported an increased fear of falling.

Fall research suggests that both reduced physical conditioning and fear of falling can increase future fall risk and reduce independence. As the pandemic eases in the United States, the poll leaders note that better awareness of this connection could help motivate adults of any age to safely increase or maintain their physical activity—especially if they have been less active or mobile due to the pandemic.

The poll finds 25% of older adults experienced a fall between the start of the pandemic in March 2020 and January 2021, when the poll was conducted. Forty percent of those who experienced a fall had more than one fall during this period.

The poll also points to specific groups of older adults—women, Black adults, older adults experiencing loneliness, and those over 65—who may need additional help to improve physical conditioning and reduce fall risk. That help could come from health and fitness providers, and family and friends.

The new report is based on answers from a national sample of more than 2,000 adults aged 50 to 80 to a poll taken in January 2021.

“Many older adults fall each year, and the pandemic was no exception. Many falls result in at least a minor injury in this age group, and a third require medical attention,” says Geoffrey Hoffman, assistant professor at the University of Michigan School of Nursing.

“Physical conditioning can make a major difference for maintaining independence, including avoiding a fall, but also how well someone reacts to and recovers from one. Focusing on prevention now, including physical health and activity but also home safety and social factors that can increase risk, is crucial.”

Less activity, more fall risk fears

More than a third of older adults (37%) reported being less physically active since the pandemic began. Nearly the same percentage say they spent less time on their feet, walking or standing, after March 2020.

This reduced activity translated into 27% saying their physical conditioning—flexibility, muscle strength, and endurance—had worsened. Mobility—the ability to move around including with a cane, walker or vehicle—declined for 25% of respondents, according to poll responses.

The poll also asked about fear of falling, which 36% of respondents overall say they experienced, and by nearly half of all poll respondents over age 65 (46%) and of women aged 50 to 80 (44%).

Among all older adults who say they fear falling, 23% says that fear increased during the pandemic. But the percentage that reported increased fear of falling was much higher among those who reported less physical activity (32%), worsened physical conditioning (42%), or worsened mobility (45%).

Falls lead to the deaths of more than 32,000 older adults each year. The number has risen steadily in recent years and is expected to continue to increase with the aging of the US population, according to the Centers for Disease Control and Prevention.

Loneliness and delayed care

The poll also reveals clues about how the loneliness and lack of companionship that increased among older adults during the pandemic might play into changes in activity levels, mobility, and fall risk, says poll director Preeti Malani, a Michigan Medicine infectious disease physician also trained in geriatrics.

The percentage of older adults reporting falls was higher—32%—among those who says they lack companionship. This group was also more likely than others to report less physical activity and worsened mobility and physical conditioning. The NPHA has issued two previous reports on the health aspects of loneliness in older adults, both before and during the pandemic.

“As life gets closer to normal, especially for the large percentage of older adults who are fully vaccinated against COVID-19, health care providers and loved ones should encourage more interactions that involve safe physical activity,” Malani says.

“We need to make up for lost time and get older adults on track, or back on track, with the kinds of movement and strengthening that can safeguard their independence by reducing their risk of falls or of major fall-related injuries. Even better if this happens in conjunction with social interaction.”

Hoffman and Malani also note another of the poll’s findings: During the pandemic, 28% of older adults injured by a fall either delayed or did not receive medical care they felt they needed. Forty percent of this group says the pandemic was directly related to this lack of care. People who have lingering effects from a fall experienced during the height of the pandemic—joint pain or reduced mobility and strength, for instance—should seek rehabilitation and other care to avoid or reduce the risk of any further issues, they add.

“Falls are a significant health and safety concern for older adults,” says Alison Bryant, senior vice president of research for AARP. “Thankfully, there are many ways you can reduce your risk of falling, including simple home modifications like using brighter light bulbs, removing throw rugs, and making sure electrical cords are tucked out of the way.”

The poll, based at the University of Michigan Institute for Healthcare Policy and Innovation, receives support from AARP and Michigan Medicine, the University of Michigan’s academic medical center.

Source: University of Michigan