Regular participation in physical activity or exercise is not only integral to the maintenance of good health and functional independence in older adulthood but also serves a primary role in the prevention of numerous chronic diseases. Conversely, physical inactivity doubles the risk of developing a disability that will adversely affect mobility as well as the ability to perform even the most basic activities of daily life. This downward spiral in physical function ultimately results in heightened risk for loss of functional independence as a result of declining health and/or falls, in particular.
Depending on the level of risk identified, physical activity may serve a primary, secondary, or tertiary role in the prevention of falls. In its primary role, regular engagement in physical activity can prevent the onset of pathology and system impairments that may lead to disability and heightened risk for falls. Slowing the progression of disease and system impairments is its secondary role, while its tertiary role lies in the restoration of function to a level that allows for more autonomy in the performance of daily activities. The focus of this keynote presentation will be to first review the research evidence that provides support for exercise as a medium for reducing fall risk and/or fall incidence rates among community-residing older adults at different levels of fall risk. While it is clear that exercise should be an essential component of any fall risk reduction program, it will be argued that there is no one size suits all intervention approach to reducing falls among older adults. Instead, the type of physical activity intervention strategy adopted should consider multiple factors, including level of fall risk, identified physical risk factors, and the physical activity preferences of older adults.
The second part of this presentation will focus on national and statewide efforts currently underway in the United States to establish fall prevention as a key public health priority. The efforts of the Fall Prevention Center of Excellence (FPCE) in California will be highlighted in this section of the presentation. The FPCE is currently engaged in developing and disseminating fall prevention tools and informational resources directed at the needs of both consumer and professional audiences; linking organizations involved in fall prevention while increasing awareness of fall prevention as an important public health issue; and helping communities build their capacity to effectively address falls in older adults through the delivery of integrated fall prevention services and "best practice" programs.