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Fall prevention

I’ll admit that I made a poor decision and after nearly three decades of medical practice I should have known better. One evening recently I was taking my dog out at night to do his business and thoughtlessly put on my slippers. With low visibility in the dark, I walked directly over an ice patch and wound up on my backside. Fortunately, nothing was hurt except my pride.

According to the World Health Organization, falls are the second leading cause of death due to unintentional injury worldwide. One out of every five falls results in an injury, such as broken bones or a head injury. The problem is especially significant among older persons in the United States, where falls are the leading cause of injury and injury death. For instance, the U.S. Centers for Disease Control and Prevention reports that over 300,000 hip fractures among the elderly occur each year in the United States.

Despite these concerning statistics, falls are not a normal part of aging. The potential risks of falls are multifactorial. Falls can result from vision problems, general weakness, difficulty with balance or walking, foot pain or poor footwear, a low vitamin D level and even hazards in and around the home.

Some medications may increase the risk of falls due to side effects such as dizziness or drowsiness. Even the use of bifocal or progressive lenses during outdoor activities such as walking can make things seem closer or farther away than they really are and can lead to increased risk of a fall.

Of course, falls don’t just happen among older persons, nor are they restricted to routine activities. Falls resulting from participation in a variety of high-impact recreational activities, including skiing, snowboarding and cycling can result in serious injury, including head injury. For this reason, use of appropriate protective gear, including a properly fitted helmet, is strongly recommended when participating in these types of activities.

The U.S. Centers for Disease Control and Prevention has identified several things that older persons may do to reduce their risk of falls. Like so many other things, prevention begins in the home. This includes decluttering your floors and stairs and removing things that you can trip over (including throw rugs), use of nonslip mats in the bathtub or shower, improved home lighting, installation of handrails on staircases and in the bathroom, and use of well-fitting supportive footwear.

You should exercise to improve your strength and balance and have both your eyes and feet checked to identify and address risks.

It is also important to talk to your health care provider to complete a falls risk assessment, to review your medications, and to check your vitamin D level.

Dr. Matthew A. Clark, a board-certified physician in internal medicine and pediatrics, works for the Indian Health Service.