Falls in the Elderly: Staying On Our Feet
Preventing injuries from falls, by Andrew Morpurgo,
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
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
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.