Falls
Falls are one of the most common reasons why older adults may lose their independence and ability to live on their own.
Falls are common. According to the CDC, one third of adults over age 65 have fallen in the last year.
A history of falling puts adults at higher risk of falling in the future.
Most falls result in only minor injury, but 5-10% of falls can result in something more serious, such as a broken bone or head injury.
Falls can lead to hospitalizations and prolonged periods of immobility, which can in turn lead to further complications like muscle weakness, pneumonia, and pressure sores.
Causes and Risk Factors
Usually, there is not one clear cause for a fall. Rather, falls are typically a result of multiple factors relating to the patient and their environment.
Risk Factors
According to the American Geriatrics Society, the biggest risk factors for falls are older age, cognitive impairment, female gender, past fall history, arthritis, foot problems, sedating medications, low vitamin D, pain, Parkinson disease, and stroke.
Other medications such as antihistamines, insulin, muscle relaxants, and medications to treat Parkinson disease, hypertension, anxiety, insomnia, and incontinence can increase risk of falls as well.
Vision problems, balance problems, muscle weakness, dizziness, and low blood pressure can also increase risk of falls.
Talk to Your Doctor
Always tell your doctor if you have a fall, even if it didn’t result in an injury. Talk to your doctor if you have a fear of falling or close call as well.
Your doctor will do a thorough investigation and ask about the circumstances and environment surrounding the fall. Your physician should also closely evaluate your medications, balance, strength, and gait.
Work with your doctor and other members of your team like family, caregiver, and physical therapist to reduce the risk of falls in the future.
Treatment and Prevention of Falls
Work with your healthcare team to reduce fall risk. Below are the most effective ways to reduce falls, according to the American Geriatrics Society.
Modify Your Home
Remove throw rugs or other tripping hazards from the ground. Keep hallways well lit. Have a professional such as an Occupational Therapist come to your home and do a home safety evaluation.
Minimize or Stop Risky Medications
Talk to your doctors about your medications and if they pose a high fall risk. If so, work with your doctor to reduce them or replace them with safer alternatives.
Address Dizziness
Talk to your doctor if you experience any dizziness. One common cause of dizziness that increases fall risk is orthostatic hypotension, which is low blood pressure upon standing up. Your doctor may recommend keeping your blood pressure a little higher, drinking more water, changing medications, or standing up more slowly to reduce the risk of falls.
Take Care of Your Feet
Work with a healthcare profession such as a podiatrist if you have any foot problems. Talk to your doctor if you have any pain or numbness in your feet. Make sure you wear well-fitting walking shoes with a non-slip sole.
Get Exercise
Get regular physical activity. Try to incorporate walking, strength training, and balance training into your routine. Tai Chi is a great way to improve strength and balance. See our page on Physical Activity to learn more.
Get Enough Vitamin D
Low Vitamin D levels can lead to fragile bones, which are more likely to break when a fall occurs. Some evidence also suggests that treating low Vitamin D can reduce risk of falls. Talk to your doctor about getting enough Vitamin D in your diet and supplementation if necessary.
Address Vision Problems
Impaired vision increases fall risk. See your eye doctor at least annually, and tell your doctor if you have any vision problems. Cataract surgery and proper eyeglasses are two examples of interventions that may be helpful.
Fall Prevention Resources
www.nof.org/patients/fracturesfall-prevention/
This website provides a great checklist for indoor and outdoor safety tips you can start implementing today.
www.ncoa.org/healthy-aging/falls-prevention/
Get fall prevention tips as well as links to many evidence-based fall prevention programs available online or in person.
www.healthinaging.org/a-z-topic/falls-prevention
Learn more about causes, management, and prevention of falls.
www.cdc.gov/steadi/patient.html
Find brochures and fact sheets about home safety, fall prevention, how to stay independent, and fall prevention exercises to do at home.