FALLS: ONE OF THE MOST COMMON GERIATRIC SYNDROMES
A fall is a sign that something else is going on and it may be more than stumbling on the throw rug. For this reason alone, if you have fallen within the last year you need to take it seriously as it is a strong indicator that you may fall again. Up to 50% of falls result in injury and about 10% require hospitalization, of which hip fractures are not uncommon. Of those that fracture a hip, 23% die within the first year and 50% go on to suffer from chronic pain, disability and fear of falling. Fear of falling can lead to a loss of physical condition which is needed to prevent future falls. Fear of falling is also associated with anxiety and a higher risk of depression.
HOW CAN I TELL IF I’M AT RISK OF FALLING?
The most significant risk factors that are associated with falling are:
- Lower extremity weakness
- Gait disturbance
- Balance disturbance
- History of recent falls
- Recent hospitalization
- Poor vision
- Using more than 4 medications
- Cognitive impairment or dementia
- Use of an assistive device
The good news is that you can alter your risk of falling. For example, if you have developed lower extremity weakness or balance problems, you can take action with specific exercises to improve leg strength and balance.
SO IF I EXERCISE I’LL BE ALRIGHT?
It’s good that you are motivated to exercise since exercise is well proven to aid in maintaining independence as we age, not just for preventing falls but also helping in maintaining cardiovascular fitness and reducing risk of memory loss. It’s never too late to start exercising! But if you have trouble staying with an exercise regiment we recommend joining a senior exercise group at a local senior center or health club, since that commitment always makes a difference and you’ll more than likely benefit from the socialization. But keep in mind, as we age there can be several reasons for falling so it is wise to address them all. For example, you can experience lower extremity weakness, poor balance, poor eye sight and take medications that can contribute to a fall. So it is wise to learn about the multiple risk factors for falling and work with someone who can help you address those areas of risk. Exercise alone can’t alter all the areas of fall risk.
Other contributing factors can be malnutrition due to low protein intake which causes loss of muscle mass. It’s important to maintain adequate nutrition as we age. Malnutrition can also lead to anemia which can cause weakness and contribute to a fall. Another contributing factor is vitamin D deficiency. Many older adults lack vitamin D in the blood at a sufficient level and taking more vitamin D is shown to reduce fall and fracture risk. To learn about vitamin D check out our article on supplements older adults should take .
Other considerations are using medications that can cause dizziness, such as blood pressure meds or meds that cause drowsiness. Using more than 4 or more medications is a risk factor in itself and it is wise to have someone who knows about falls to review your medications.
BUT IF A TAKE FOSAMAX I WON’T BREAK A HIP, RIGHT?
Keep in mind that over 95% of fractures are from trauma, or falling, and that taking a drug like Fosamax, although of benefit in the long run, does not quickly impact on reducing your risk of a life-altering fracture. Our concern is that we see too many people believe that by taking a drug like this will prevent a fracture when, in fact, 100 people have to take this drug for 5 years to prevent one hip fracture! Those are not exactly great odds. So, it’s important to understand that if you have osteoporosis, a drug like Fosamax is appropriate but it should not be relied upon and the best way to quickly reduce your risk of a fracture is to reduce your risk of falling. Other drugs that work like Fosamax are Actonel and Boniva, which are oral forms, and there is the once yearly injectable drug Reclast. For more on these medications check our article titled Bone Health Drugs: More Harm Than Good?