One of the reasons falls are so fatal for old people is because elderly people in our society rarely stay active. Look at cultures like the Chinese, where you so elderly women up in the morning doing Taichi, or working out on those weird outdoor gym sets in the rest of the day. Maintaining strength and flexibility during old age helps mitigate damage from falls a lot.
Physical deterioration is often a self-fulfilling prophecy,
The real reason falls are so fatal for the elderly is because the victims become immobalized, causing them to become less active. After a fall, many elderly people are bed-ridden which causes a whole host of greater health problems which are the actual killers.
But then good health and daily activity are the best ways of preventing falls, (along with balance training and physiotherapy, especially after a surgery or stroke) so yes it is a cycle as you say.
I don't agree with it being primarily a cultural thing though. Daily exercise is an individual choice. There's a guy in my new building who I see all the time, he just walks to the end of the hall and back many times each day. Each lap probably takes him 10 minutes. But he chooses to stay active, even in very old age.
Daily exercise is an individual choice, but humans are social beings. An implicit societal framework for being physically active helps at the margins... and the margins are pretty large.
the life expectancy at birth for China in 2011 was 73.47 years (CIA World Factbook (2011 estimates)) compared with 78.37 for the U.S and 80.05 for the UK.
So one reason that all those old Chinese people may appear so mobile is that they aren't quite as old as you might expect.
Physical deterioration is often a self-fulfilling prophecy,