Preventing Falls in the Elderly: Causes and Prevention

The causes of falls are known as risk factors. Although no single risk factor causes all falls, the greater the number of risk factors to which an individual is exposed, the greater the probability of a fall and the more likely the results of the fall will threaten the person's independence.<br /> <br /> Many of these risk factors are preventable. As obvious as it may sound, a lack of knowledge about risk factors and how to prevent them contributes to many falls. Some people believe that falls are a normal part of aging, and as such are not preventable. Lack of knowledge leads to lack of preventive action, resulting in falls.<br /> <br /> Discussed below are five key risk factors of falls among older adults. Preventive measures for each factor are briefly listed. No attempt is made to provide a comprehensive description of preventive measures. Refer to the references listed at the end of this fact sheet for more detailed information.<br /> <br /> Factor #1: Osteoporosis<br /> Osteoporosis is a condition wherein bones become more porous, less resistant to stress, and more prone to fractures. Caused by hormonal changes, calcium and vitamin D deficiency, and a decrease in physical activity, osteoporosis is a chief cause of fractures in older adults, especially among women.<br /> <br /> What is debatable is whether brittle bones break after a fall, or break when stressed and in turn cause a fall. In either event, a decrease in bone density contributes to falls and resultant injuries.<br /> <br /> Prevention Tips<br /> # Eat or drink sufficient calcium. Postmenopausal women need 1,500 mg of calcium daily. Calcium-rich foods include milk, yogurt, cheese, fish and shellfish, selected vegetables such as broccoli, soybeans, collards and turnip greens, tofu and almonds. <br /> # Get sufficient vitamin D in order to enhance the absorption of calcium into the bloodstream. Vitamin D is formed naturally in the body after exposure to sunlight, but some older adults may need a supplement. <br /> # Regularly do weight-bearing exercises. <br /> <br /> Factor #2: Lack of Physical Activity<br /> Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility. All contribute to falls and the severity of injury due to falls.<br /> <br /> Prevention Tips<br /> # Engage regularly (e.g., every other day for about 15 minutes daily) in exercise designed to increase muscle and bone strength, and to improve balance and flexibility. Many people enjoy walking and swimming. <br /> # Undertake daily activities in a safe manner, such as reaching and bending properly, taking time to recover balance when rising from a chair or bed, learning the proper way to fall, and learning how to recover after a fall. <br /> # Wear proper fitting, supportive shoes with low heels or rubber soles. <br /> <br /> Factor #3: Impaired Vision<br /> Age-related vision diseases can increase the risk of falling. Cataracts and glaucoma alter older people's depth perception, visual acuity, peripheral vision and susceptibility to glare. These limitations hinder their ability to safely negotiate their environment, whether it be in their own home or in a shopping mall. Young people use visual cues to perceive an imminent fall and take corrective action. Older adults with visual impairments do not have this advantage to the same extent.<br /> <br /> Prevention Tips<br /> # Have regular checkups by an ophthalmologist to discern the extent of age-related eye diseases such as cataracts and glaucoma. <br /> # Use color and contrast to define balance-aiding objects in the home (e.g., grab bars and handrails). <br /> # Add contrasting color strips to first and last steps to identify change of level. <br /> # Clean eye glasses often to improve visibility. <br /> <br /> Factor #4: Medications<br /> Sedatives, anti-depressants, and anti-psychotic drugs can contribute to falls by reducing mental alertness, worsening balance and gait, and causing drops in systolic blood pressure while standing. Additionally, people taking multiple medications are at greater risk of falling.<br /> <br /> Prevention Tips<br /> #Know the common side effects of all medications taken. <br /> #Talk with your physician or pharmacist about ways to reduce your chances of falling by using the lowest effective dosage, regularly assessing the need for continued medication, and the need for walking aids while taking medications that affect balance. <br /> # Remove all out-of-date medications and those no longer in use. <br /> # Have a physician or pharmacist conduct a "brown bag" medicine review of all current medications. <br /> # Limit intake of alcohol as it may interact with medications. <br /> <br /> Factor #5: Environmental Hazards<br /> At least one-third of all falls in the elderly involve environmental hazards in the home. The most common hazard for falls is tripping over objects on the floor. Other factors include poor lighting, loose rugs, lack of grab bars or poorly located/mounted grab bars, and unsturdy furniture.<br /> <br /> Source: Colorado State University Extension<br /> <br /> Debbie Wilburn is County Agent/Family and Consumer Science Agent with Hall County Cooperative Extension (770)535-8290.