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Falls in the Elderly: Staying On Our Feet

Falls in the Elderly: Staying On Our Feet

Preventing injuries from falls, by Andrew Morpurgo, M.D.

According to the New England Journal of Medicine, the “oldest old” is the fastest growing age group in this country. These are people over the age of eighty-five, and while they make up only 1.5 percent of the general population, they use more health care services than any other sector of the population.

One of the most common injuries this age group suffers is broken bones as a result of falling down. For every 1,000 people over eighty-five, twenty-nine will suffer a hip fracture in any given year and one-quarter of them will die within a year of the accident. Given that we know a fall can have serious consequences, it’s a good idea to take positive steps now to decrease our chances of falling and to mitigate possible injuries if we should happen to take a spill.

What are the most common causes of falls in the elderly?

Knowing the common causes of falling can help us (and those we love) avoid accidents. Almost 40 percent of falls are caused by tripping. Many of these occur in the house when someone trips on a throw rug, a piece of furniture that has been moved, or an electric cord. Getting up in the middle of the night in a dark house can also be dangerous. Outside, the environmental factors to be aware of are street curbs, snow, and ice.

Illness and confusion resulting from medication causes close to 20 percent of falls. Orthostatic hypotension (that light-headed feeling we sometimes get when we stand up too quickly) from prolonged bed rest, dehydration, and certain medications is another common cause of falls. And for the extremely frail elderly, overall weakness and lack of balance can lead to falls.

How can we protect ourselves from injuries related to falling?

Once we reach the age of sixty-five, there really is a “use it or lose it” physiology that takes hold, and our ability to do certain things diminishes if we don’t stay active. All of the recent research shows that regular exercise, a well-balanced diet, and nutritional supplements are a good way to counteract weakness and frailty in older adults. Moreover, exercise gives us confidence and prepares us physically to recover if we do fall. Walking is excellent exercise for all ages; it helps to keep our legs strong and our visual coordination acute. By joining a group like the mall walkers, you can walk regardless of the weather. If you have already had an injury, exercising in water may be easier for you.

Have a check-up with your doctor once a year to eliminate medical causes for falling, such as heart disease (which can make you faint). Be sure to have your vision checked regularly; you want to be certain you are seeing as clearly as possible. It might be helpful to have a visiting nurse service do a safety evaluation of your house to identify possible tripping hazards. Installing strategically placed night lights with sensors that activate when the sun goes down can make it safer for you when you get out of bed in the middle of the night.

Exercising common sense goes a long way toward preventing falls, too. Take your garbage out to the curb during daylight hours, and don’t wait until it’s dark to run your errands. Also, don’t be afraid to use a cane if you need one; a cane will not prevent you from falling if it is sitting in a closet.

Sometimes we forget that our bones are healthy, living tissue that changes over time. While we can all expect to lose bone mass as we age, there are things we can do to slow the progression. Exercise, proper nutrition, certain medications, regular check-ups, and making our environment as safe as possible will help to keep us on our feet as we age.

Dr. Morpurgo is a board-certified physiatrist, specializing in rehabilitation and physical medicine. He is director of rehabilitation services at Cayuga Medical Center, and can also be reached at his practice, at (607) 277-4097.

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