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Mobility and Falls

Good mobility is crucial in healthy ageing, as it allows older adults to maintain their independence, participate in daily activities, and engage in social and community life. Mobility is more than just walking, it’s about having the strength, flexibility, and balance to move safely and confidently, whether that means climbing stairs, getting out of a chair, or joining friends for a walk.

Determinants of mobility

Limited mobility is increasingly common in older adults, affecting approximately 35% of persons aged 70+ and most persons over 85 years. Mobility limitations have been associated with increased falls risk, hospitalisation, decreased quality of life, and even mortality.  Limitations include:

  • Weaker muscles
  • Poor balance and coordination
  • Lack of flexibility
  • Impaired gait
  • Cognitive decline

Recommendations

Planned, structured, and repetitive movement can preserve or improve physical determinants of mobility, such as muscle strength, balance, and flexibility. To improve mobility and prevent falls, it is recommended that all older adults participate in two to three hours of balance, mobility and strength training per week.

Recommended interventions to improve mobility commonly consist of task-specific mobility training and balance-challenging exercises, including:

  • Practicing standing up and sitting down
  • Walking in a straight line
  • Stepping and walking in different directions
  • Going up and down stairs
  • Performing dual-tasking exercises (reciting the alphabet backwards, turning head side to side, counting backwards in 3s, etc.).

Ensure that exercises for older adults are challenging, safe, and achievable. Review and progress exercises regularly to maintain an optimal level of difficulty. If you are working with older adults with mild cognitive impairment or mild to moderate dementia, support them to undertake exercise to prevent falls if they choose to.

Additionally, tai chi, individual and group exercises, and resistance training can all reduce the risks of developing mobility limitations.  

Assessments for mobility levels

There are a range of assessments available to measure older adults’ mobility levels, including performance-based assessments, performance and judgement-based measures and self-report measures. It is also important to assess the individual’s personal aids and mobility in unfamiliar environments.  

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