Avoiding falls: For elderly, it’s a serious challenge

We all face new health challenges as we age. One important health concern among the elderly is the risk of injury from falls.

This risk results from many variables, including acute and chronic illness, medication side effects and changes in the body related to the aging process.

The inherent age-related risk factors for falls are many. Aging can lead to declines in balance, cardiovascular function, muscle tone and walking stability. Age-related problems with the vestibular system can produce dizziness and imbalance. Lower leg weakness resulting from reduced muscle tone affects stability.

Visual impairments common among older people increase the risk of falls. These include loss of depth perception, adaptation to dark, decreased sensitivity to contrast and frank vision loss. Further, the use of multifocal corrective lenses, common in the elderly, has been shown to increase the risk of falls.

Chronic illness among older people also contributes to fall risk. For instance, arthritis may decrease joint mobility. History of stroke can produce problems with neurologic function, affecting walking and balance. Cognitive impairment, including dementia, can increase the risk.

Some older people also may develop a condition known as orthostatic hypotension, which produces lightheadedness when arising too quickly.

The risk of falls has been shown to be higher among diabetics, presumably because of disease-related adverse effects on nerve function.

Acute illnesses such as infection, dehydration or arrhythmia have also been shown to increase the risk of falls among older people.

Not least among the risk factors for falls in the elderly are medication side effects. This risk logically increases with the number of medications used. Culprits include nonprescription medications (such as drugs for allergy) and prescription medications such as those used in the treatment of high blood pressure, sleep disorders, prostate disease and pain just to name a few.

Apart from disease and age-related conditions which increase fall risks, environmental variables play a role. Low lighting, stairs, icy sidewalks, uneven floor surfaces (such as throw rugs) and slippery bathroom surfaces have all been implicated as risk factors. Improper footwear can also play a role. In one study, shoes with thin firm soles improved balance.

The consequences of falls among the elderly range from minor injury to serious disability and even death. Among the most feared injuries are hip fracture and head injuries. Yet even less severe injuries can result in significant impairment among older people.

Prevention of falls focuses on reducing the impact of individual risk factors. This may include home-safety assessments and the use of assistive equipment (such as canes, walkers and improved home lighting) for those at highest risk.

For most elders, reducing risk of falls can be accomplished by maintaining an active lifestyle and recognizing individual limitations. Walking 15 to 30 minutes daily can help improve balance and muscle tone. It is also important to meet with your physician to optimize control of chronic health conditions and review potential medication side effects.

Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.