Mobility refers to a person’s ability to move independently and safely in their environment. It involves walking, transferring, balance, and coordination. In older adults, mobility is a determinant of:
- functional independence
- quality of life
- falls risk.
Limited mobility is increasingly common in older adults, affecting approximately 35% of persons aged over 70.
Reduced mobility can be a result of changes to a person’s physical, cognitive, neuromuscular, and psychological health, such as:
- weaker muscles
- poor balance and coordination
- lack of flexibility
- difficulty walking or transferring
- slower reaction times
- cognitive decline.
To improve mobility and prevent falls older adults should aim to do 2–3 hours per week of exercise, and include exercises that target balance, mobility, and strength every other day.
How can I help older adults to improve their mobility?
Planned, structured, and repetitive movement can maintain or improve physical determinants of mobility, such as muscle strength, balance, and flexibility.
Task-specific exercises help older adults perform everyday movements like standing up, reaching, stepping over an obstacle, or changing directions while walking.
Task-specific exercises can involve:
- standing with a narrow base of support
- stepping over objects
- standing up and sitting down
- stepping and walking in different directions, speeds, and environments
- walking up and down stairs
- performing dual-tasking exercises (reciting the alphabet backwards, turning head side to side, counting backwards in threes, etc.).
Exercises that challenge balance and functional mobility is effective in preventing falls, including:
- standing and/or walking heel-toe
- standing on one leg
- heel and toe raises
- marching on the spot
- tai chi
- dancing.
Programs that include resistance training can improve muscle strength and neuromuscular function, such as:
- Otago
- LiFE
- Active Balance
- Strength for Life.
Good practice points for helping older adults improve their mobility
- Make programs progressive, challenging, and safe.
- Encourage home-based strength and balance training.
- Support choice and dignity of risk.
- Set meaningful goals and tailor exercises to the person’s needs and environment.
- Offer online exercise programs for those in rural or remote areas.
- Use cognitive-motor activities like exergames.
Always assess an older adult’s abilities before prescribing balance, mobility and strength exercises.
Screening and assessment tools help choose the right exercises, adapt them to individual needs, and track progress in mobility over time. To assess older adults’ mobility, use validated tools (e.g., FROP-com, Timed Up and Go, Sit-To-Stand, 4-Stage Balance) and:
- identify any history of falls
- consider cognitive status, medication use, and environmental factors
- ensure walking aids and shoes are safe and correctly fitted
- assess mobility in both familiar and unfamiliar environments
- consider psychological factors such as concerns of falling.
Caution: Balance exercises can cause falls if not done safely. Choose exercises that align with the person’s ability. Always have support nearby such as a sturdy chair, table or wall. Supervise if needed, especially for older adults with frailty.
Guidelines
For evidence-based recommendations on improving mobility in older adults, refer to the:
- Australian Commission on Safety and Quality in Health Care’s Falls Guidelines (2025) for community settings
- World Falls Guidelines for Prevention & Management of Falls in Older Adults.
