Falls in the Elderly: Preventing Falls in Older Persons

Many older people are afraid of falling, breaking a bone and thereby losing their independence. As understandable as this is: Moving less for fear of falling can have the opposite effect. After all, anyone who stops being physically active is at greater risk of falling than someone who walks a lot every day, for example.

It is important to recognize avoidable dangers in everyday life and to look for remedies. Appropriate movement training can help to stay flexible and prevent falls. Which measures are useful for an elderly person depends primarily on their personal state of health.

Causes and Risk Factors

Falls can be caused by obstacles and tripping hazards in your own home or in the immediate vicinity. These include, for example, tall carpet edges and skirting boards, loose cables, smooth floors or slippery bath mats. It can also be problematic to only go to the toilet in socks at night, for example over smooth parquet.

However, falls can also be the result of certain health problems. Examples of this are visual impairments, occasional circulatory weakness or dizziness due to high or low blood pressure and some diseases that disturb the sense of balance . Some medications can also affect alertness and reflexes, leading to falls. These drugs mainly include certain sedatives and others Psychotropic drugs. Also interactions between different drugs can increase the risk of falls.

Anyone who has already fallen has an increased risk of falling again. However, there are ways to reduce this risk.

Frequency

It is estimated that around 30 out of 100 men and women over 65 years of age fall once a year. The rate is higher for home residents than for people who live at home. Most falls, however, go off lightly even in people over 65 years of age and have no serious health consequences.

Consequences

Sometimes a fall results in a bruise or abrasion. However, fractures occur in less than 1 in 10 falls. When a bone fracture occurs, it is usually the forearm bones that are affected.

Fractures in the hip or thigh can also cause serious complications and limitations. They can also make longer hospital stays necessary. Especially for people of old age, falls with serious consequences increase the risk of being in need of care.

Prevention

Some measures to prevent falls are relatively simple. For example, you can check your own apartment for tripping hazards and eliminate them. What is also useful depends very much on the personal and health situation of an elderly person. This can be, for example, exercise programs, walking aids, the treatment of certain health problems, new glasses or even stopping medication.

What older people can do to prevent falls

Falls can happen at any age. However, because a fall can have serious health consequences, especially for older people, it is particularly worthwhile for them to prevent falls as much as possible. Some measures to prevent falls are also quite simple.

A simple and effective measure is to eliminate tripping hazards in the home environment. For people with an increased risk of falling who live at home, it can be very helpful to identify and eliminate such tripping hazards in the home and in the entrance area. This measure seems to be most effective when carried out with the help of an occupational therapist. It is particularly useful for people with poor eyesight to eliminate tripping hazards.
Can exercise programs help?

For people who live at home and are at high risk of falling, an age-appropriate exercise program that strengthens muscles and improves a sense of balance can be useful . Studies show that such programs can prevent falls. This applies to both group programs and individual training at home. However, it is important to choose a type of exercise that suits your physical abilities.

Older people who live in nursing homes tend to have more health problems than others. Even here, an exercise program can be useful. Studies show that even more disabled people in nursing homes fall less often if they are offered fall prevention programs that are tailored to them. Such programs are usually designed by various specialists, for example from the following areasphysical therapy, Geriatric care and geriatrics. Teams made up of specialists from various disciplines are more likely to recognize individual risks and better adapt measures to the individual.

Can stopping certain medications reduce the risk of falls?

Some medicines alone or in combination with other medicines can increase the risk of falling. Studies show that the risk of falls can be reduced if unnecessary medication is stopped. To do this, it is helpful to compile a list of all the medications you have taken, for example with a form that you can print out . It is best to discuss with a doctor whether all medication is really necessary and whether there could be any interactions.

It is known that certain Psychotropic drugsincrease the risk of falls. People with symptoms such as restlessness, insomnia , anxiety or exhaustion sometimes take such drugs, for example benzodiazepines. Gradually stopping these drugs can reduce the risk of falls. There Benzodiazepinescan become addictive after a few weeks even in low doses, stopping them is not always easy .

Can vitamin D prevent falls?

Recent studies suggest that vitamin D can help prevent falls when someone has low vitamin D levels. Vitamin D shows no benefit in people with normal vitamin D levels. The vitamin D level can be determined by doing a blood test.

Vitamin D is said to strengthen the muscles. In addition, vitamin D promotes the absorption of when neededcalciumand phosphate from the intestines . A sufficient calcium level is important for normal bone metabolism and therefore also for the stability of the bones. Vitamin D may be more effective when taken along with calcium is taken.

Vitamin D and calciumcan have undesirable effects. Above all, this includes the formation of kidney stones . European and US authorities recommend no more than 1000 to 1300 mg daily calciumin the form of food supplements .

What can people with certain health problems do?

Some studies also show that people can reduce their risk of falls by getting treatment for certain health problems:

People with cataracts fall less if they surgically remove the clouded lens and replace it with a plastic lens so that they can see better again.
Certain cardiac arrhythmias could be a Pacemaker be useful.
People with foot problems can use shoe insoles and foot and joint exercises to prevent falls.

What else could help?

In some studies, experts from medicine, nursing, physio or Occupational therapythe individual fall risk of older people and suggested suitable measures to prevent falls. For example, it was checked whether the participants had poor eyesight or other health problems that increase the risk of falling, and whether they could benefit from glasses or walking aids, for example. These customized measures proved helpful.

In winter, snow chains or spikes for shoes could reduce the risk of falls outside the home. The chains are placed around the sole of the shoe and, like snow chains on a car, should prevent you from slipping when it is slippery. In one study, this measure helped prevent falls.

Even though a lot can be done to prevent falls, not every fall can be prevented. Therefore it is especially suitable for the elderly and people with brittle bones (osteoporosis) important to know how you can strengthen your bones and thereby protect them.