Exercising balance and leg strength for people over 60, plus home modifications

13. Exercising balance and leg strength for people over 60, plus home modifications

Cost: Aim to practice balance exercises two to three times per week, each session lasting 30 minutes — activities like Tai Chi work well. Installing non-slip mats, handrails, and night lights in bathrooms and stairways costs anywhere from a few dozen to several hundred yuan. The real challenge is maintaining this routine over the long term.

In plain terms: Doing balance exercises such as Tai Chi two or three times weekly can cut the overall number of falls among older adults by roughly 23%. It also reduces the proportion of people who have fallen at least once by about 15%. Adding simple home modifications — like anti-slip mats and handrails — can lower fall rates by another 20% or so. Falls are the leading cause of injury-related deaths among Chinese seniors aged 65 and above; alarmingly, over half of all falls happen right at home.

Benefit: Cochrane analyzed 108 separate trials involving 23,407 participants. Collectively, these studies show that regular exercise lowers fall rates among older adults by 23%. The relative risk of falls dropped to 0.77, with a 95% confidence interval ranging from 0.71 to 0.83. The proportion of individuals experiencing at least one fall also fell by 15% (relative risk 0.85). Professional home safety assessments and modifications further reduced fall rates by roughly 20% (RR 0.81; 95% CI 0.68–0.97). Practicing Tai Chi specifically lowered fall risk by about 29% (RR 0.71). In China, falls remain the top cause of injury-related mortality for seniors over 65; data from 2018 indicates that 55.97% of all falls among this age group occur at home.

Evidence grade: A

Sources: Sherrington C et al. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. <https://doi.org/10.1002/14651858.CD012424.pub2>; Gillespie LD et al. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. <https://doi.org/10.1002/14651858.CD007146.pub3>; Lu Z et al. (2021). Characteristics of Falls Among Older People — China, 2018. China CDC Weekly. <https://doi.org/10.46234/ccdcw2021.013>

Notes: This recommendation applies to seniors aged 60 and above who live independently at home rather than in nursing homes. The studies referenced here focus on the total number of falls, not on actual mortality rates. It’s important to note that the path from a fall to a hip fracture — and ultimately death — can be very short for older adults.