Tai Chi Prevents Falls in the Elderly

Abstract & Commentary

By Joseph E. Scherger, MD, MPH, Professor, University of California, San Diego; Dr. Scherger reports no financial relationship to this field of study.

Synopsis: A randomized controlled trial in Australia showed that a 16 week program of tai chi reduced falls by 33% in a group of elderly persons.

Source: Voukelatos A, et al. J Am Geriatr Soc. 2007;55:1185-1191.

A group of investigators in Sidney, Australia recruited 702 seniors (age 60 and up, mean age 69) to participate in a randomized controlled trial of a 16-week tai chi program to reduce falls. The study followed the seniors during the 16 weeks of weekly one hour classes, and for 24 weeks afterwards. The control group was allowed to participate in the tai chi program after the study. Seniors with degenerative neurologic conditions such as Parkinson's disease, those with dementia, prior stroke and severe arthritis were excluded.

There was very little difference in falls between the two groups during the 16-week course period, but the rate of falls was 33% less in the tai chi group during the 24 follow-up weeks. There were significant differences in changes favoring the tai chi group on five of six balance tests.

Commentary

I recently had an elderly patient fall and break her hip. She went from being independent to being confined long term in a nursing home, never fully recovering from the trauma. She died 6 months after the fall. Falls in the elderly are a leading cause of death and disability and preventing them is a top priority in geriatric care.

This is one of several recent studies showing that tai chi improves balance and reduces falls in the elderly.1-3 Tai chi is especially suited for the elderly with its slow motions and low impact. In traditional Chinese culture, the elderly, alone or in groups, start the day with tai chi exercises.

Instruction in tai chi is available in most areas. It should probably become part of physical therapy programs. I know that I will recommend it much more often, and as I approach 60, become trained myself.

References:

1. Li F, et al. J Gerontol A Biol Sci Med Sci. 2005;60:187-194.

2. Lin MR, et al. Phys Ther. 2006;86:1189-1201.

3. Zeeuwe PE, et al. BMC Geriatr. 2006;6:6.