National Falls Prevention Awareness Day is observed on the first day of fall (today!) to increase public awareness and promote activities to reduce falls among older adults. This year's awareness day is themed "Standing Together to Prevent Falls," and 46 states are planning to participate. National Falls Prevention Awareness Day is just one example of the tremendous work over 70 professional organizations, including APTA, federal agencies, and 42 state falls prevention coalitions have done through the Falls Free Initiative.

According to the Centers for Disease Control and Prevention (CDC), one-third of older adults fall at least once each year. Falls are the leading cause of fatal injury and nonfatal trauma-related hospital admissions among older adults. Muscle weakness, balance impairments, and walking difficulties are among the leading risk factors for falls among older adults. Fortunately, various types of exercise can lessen the impact of these factors and reduce one's chances of falling.

The US Preventive Services Task Force recently supported exercise or physical therapy and Vitamin D supplementation to prevent falls among community-dwelling older adults. These recommendations are also supportive of those proposed by the American Geriatrics Society, which recommends balance, walking, and strength training to reduce falls risk.

The Physical Activity Guidelines for Americans (PAG) also recommend balance training at least 3 times per week for older adults at increased risk for falls. This is in addition to the general recommendation for a minimum of 150 minutes of moderate-intensity or 75 minutes of vigourous-intensity aerobic exercise per week and 2 days per week of strength training.

Balance training should be challenging and progressive in difficulty (such as reducing base of support and/or increasing movement in multiple directions). Group or individual programs that combine balance and strengthening exercises, such as tai chi, have been proven to effectively reduce falls among older adults.

Evidence-based balance exercise programs can be offered in any number of settings. It is also acknowledged that a variety of other healthy aging programs can be strategically offered within facilities to promote and sustain behavior change, address intermediate risk factors or barriers, or serve as entry programs for referral to more targeted fall prevention programming. Many of these programs are already found within communities supported by the US Administration on Community Living. Research supports a minimum of 50 hours of exercise, over a minumum of 12 weeks (6 months is best) to affect balance and falls, so physical therapists need to partner with agencies that can help to augment or supplement our plans of care.

There are many examples of successful partnerships among community agencies and exercise professionals to offer evidence-based and best-practice programs that deliver the recommended type and amount of exercise. Community agencies are also in a strategic position to offer assistance with marketing, recruiting participants, and providing activity space. Potential partners include senior centers, older adult housing, churches, fitness and wellness centers, and nutrition sites.

APTA provides website resources on falls prevention to its members and promotes the Falls Prevention Awareness Day through its e-newsletter. Other awareness and planning resources are also available from the National Coalition on Aging Center for Healthy Aging. How can your organization and members join together to help your communities' older adults improve balance and reduce falls?

Guest bloggers: Lori Schrodt, PT, PhD, Chair of the Health Promotion & Wellness Special Interest Group, Section of Geriatrics, American Physical Therapy Association; (Bonita) Lynn Beattie, PT, MP, MHA, Vice President, Injury Prevention Lead, Falls Free Initiative; Center for Healthy Aging; National Council on Aging; and physical therapist students from Western Carolina University, Andrea Cahoon, Sherrie Flory, Anna King, Caitlin Laemmle, Kenneth Richards, and Monica Vargas.

What makes a healthy community? One answer is contained in the physical spaces and services that enable older adults to engage in healthy behaviors. Bike paths, walking trails, outdoor fitness spaces, meditation areas and labyrinths are just a few examples of infrastructure that can inspire and engage older populations. Another example can be found in upgraded senior centers providing spaces for community gardens and offering numerous educational campaigns and incentives to help lead their population towards a healthier life across the lifespan.

The second answer lies in the catchphrase of "personal responsibility." For a community to be healthy, the people living in that community need to take action. Here are 10 tips that can help you inform your older consumers about ways in which they can lead a healthier life, thus creating a healthy community. Here we go...

1. Expectations: If they have been following a healthy lifestyle up until now, simply tell them to keep going. If they need to make changes, help them to anticipate succeeding, not failing - and don't let age be a barrier. Research has shown that thinking positively about getting older can extend their life by as much as 7.5 years.

2. Enthusiasm: Few people are thrilled with every aspect of their lives, but many have at least one area - family, friends, work, avocation - that they feel good about. Identify an activity or connection that sparks their enthusiasm, and make it their lifeline; try to get them to extend that enthusiasm to other areas of their life.

3. Energy: Having the energy and motivation they need to age well are hallmarks of healthy living. If they are fatigued all the time, don't let apathy and lethargy drag them down; suggest they get a checkup to try to determine the cause and the solution.

4. Eating: Eating a balanced diet and attaining/maintaining a normal weight are keys to physical and mental health; if they need to lose weight or make changes in their diet, keep their expectations high - they can do it!

5. Exercise: Staying physically active fuels the body and mind. If they are already exercising regularly, encourage them to keep it up. It they are just getting started, help them to understand their skill level, get them to set goals and progress at their own pace, and get them to be consistent.

6. Engagement: Volunteers have higher levels of well-being and life satisfaction than those who don't volunteer; volunteering and other forms of civic and social engagement can play an important role in the maintenance of good health later in life. Get them involved in the community.

7. Emotions: Everyone feels down at times, but full-blown depression is a major cause of disability. If they are feeling out of sorts for two weeks or more, talk with their doctor or have them take an online screening test. In many instances, simply exercising and eating right can change their mood.

8. Education: Lifelong learning is important to living an independent and fulfilling life. Suggest your customers start now to learn a new area of knowledge or physical activity. It's good for the brain.

9. Effort: Changing expectations and embarking on new behaviors takes energy and effort, but the results for your customer will be well worth it.

10. Enjoyment: A healthy life generally is a joyous one. Suggest ways in which your customers can savor the process of being or becoming active, engaged, and truly alive.

How will you use this information to help build a healthier community in your town or city?

They say two things are guaranteed in life: death and taxes. I would like to add a third... aging.

We age from the moment we are born until the moment we draw our last breath. We all experience this natural life process; some of us just experience it for a shorter time than others. Today, our longer life spans are creating challenges and opportunities as we enter unknown territory.

Among these challenges is the aging population's continual fixation on staying young and on top of its game. This desire to discover the fountain of youth has spawned numerous million-dollar industries. Whether its Viagra, nutraceuticals, or tummy tucks, these markets are being driven by aging Boomers who want solutions and want them now. Just look at celebrity Boomers Randy Jackson of American Idol and Al Roker of NBC's Today Show; both had gastric bypass surgery. After a lot of nip and a little tuck, they are thin again. But these celebrities took a major risk when undergoing their operations, as three out of every 200 people die after weight loss surgery.

The Hunt is On

Plastic surgery has gone mainstream. So, too, have the cosmetic companies that claim to offer solutions for wrinkles, age spots and cellulite. Of course, let's not forget the so-called medical breakthrough of a few years ago: the World's First Anti-Aging Pill. The pill's dramatic press release stated that the "promising discovery has been proven to quickly reverse the aging process by repleneshing the body's own production of youth hormone to normal 25-year old levels." Hard to believe, I know, but let's try to image what such a product could mean.

If we can lose weight by having surgery and build muscle by taking a pill, why spend time sweating off those pounds and building that noteworthy physique? If we can take "elixirs of life" that promise to recapture the vitality of youth, why get out of bed to walk or run on a dark, cold morning in winter? These are good questions to ask, but the fact is that all the surgeries, pills and elixirs have a downside, whether their claims are ture or false. About 40% of Americans age 50 and older believe anti-aging products are basically "hogwash," while another 36% are "curious, but skeptical." Although more than 20% of people in this age group say these products can "work sometimes," just 3% say they like them a lot.

To Age or Not to Age

As we hear stories about increasing numbers of Boomers and older adults having their stomachs stapled or taking expensive remedies, we must recognize that most of these new industries focus on physical beauty rather than on internal health. Think about it. We can have a great exterior, but still develop heart disease, hypertension, osteoporosis, diabetes and depression. But by making healthier lifestyle choices, eating properly, and exercising, we can prevent, control or retard much of the damage. Even today, physicians can prescribe pills to treat diabetes, depression and hypertension. However, we can address these health issues as well and if not better - and for much less money - through exercise, proper nutrition, and lifestyle modifications.

The reality is, we don't live in a perfect world. And the pursuit of the perfect exterior, whether young or old, while neglecting the perfect interior, could have a major impact on the health of aging Boomers. Our goal must be to help these individuals achieve their ideal self, both inside and out. By broadening the focus to include the internal, we can help our members - and our businesses - enjoy better health.

Expanding the Message

To accomplish this lofty task, take a step back and think of the market as your child. What advice would you give to your child, who you love dearly, and who you want to see grow up healthy and living a long life. Would you put them in front of a mirror and critique them, testing their body fat to see how they compare with the rest of the population? Not most parents. You are more likely to talk to them about what it means to be healthy, from the inside out, offering the support they need to grow and accomplish a healthy lifestyle.

Now think of members in your community. Do you help people you care about to be better from the inside out? Do you give them the support they need to be succesful?

What we in the field of physical activity and exercise offer the world is the ability to lead a high quality life, and there is no better time to start a physical activity program than during National Physical Fitness and Sports Month.

So, how will you help your community members shift their focus from perfection to prevention?