Useful reinforcements! Nice article. Well presented, in a nut-shell, even 
though many of the reasons and facts are well known to us. Please pass it 
on..it may avoid a fall! And that would certainly be worth it!

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http://www.island.lk/index.php?page_cat=article-details&page=article-details&code_title=37856
Elder Health-Why do they fall?
By Dr.Achala Balasuriya MD
Consultant Physician
(Special Interest- Elderly Care medicine)


Falls among elders is a common cause of morbidity , hospitalization , 
disability and death. Nearly a third of the elderly have falls that trigger a 
chain of events that usually have them succumb to the situation or leave them 
bed-ridden till the end comes. With age, the ability of the body to heal itself 
reduces considerably and the immunity drops. The muscles and ligaments tend to 
get more lax with bones becoming more brittle and porous. Under these 
circumstances, even a trivial looking fall may prove fatal.


Common causes of falls


Reduced muscle strength, coordination and reflexes


Poor sensation in the lower extremities due to diabetes or degenerative 
conditions


Poor balance due to neurological diseases, hypothyroidism or ear problems


Poor vision


Postural drop in blood pressure


Seizure disorders


Strokes, transient ischemic attacks


Abnormalities of cardiac rhythm


Multiple medication use


Environmental hazards eg poor lightning ,carpets, rugs, clutter etc


Osteoporosis
Osteoporosis is a one major risk factor for falls. 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


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.


Prevention Tips
"Eat or drink sufficient calcium. Postmenopausal women need 1,500 mg of calcium 
daily. Calcium-rich foods include milk, yoghurt, cheese, fish and shellfish, 
selected vegetables such as broccoli, soybeans, tofu and almonds.


"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.


"Regularly do weight-bearing exercise.


Lack of Physical Activity
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.


Prevention Tips
"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.


"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.


"Wear proper fitting, supportive shoes with low heels or rubber soles.


Impaired Vision
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.


Prevention Tips
"Have regular checkups by an ophthalmologist to discern the extent of 
age-related eye diseases such as cataracts and glaucoma, macular degeneration 
etc.


"Use colour and contrast to define balance-aiding objects in the home (e.g., 
grab bars and handrails).Add contrasting colour strips to first and last steps 
to identify change of level.


"Clean eye glasses often to improve visibility.


Medications
People taking multiple medications are at greater risk of falling 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.


Prevention Tips
"Know the common side effects of all medications taken.


"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.


"Remove all out-of-date medications and those no longer in use.


Limit intake of alcohol as it may interact with medication


Environmental Hazards
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.


Prevention Tips
It is useful to conduct a walk-through of your home to identify possible 
problems that may lead to falling.


Outdoors
Repair cracks and abrupt edges of sidewalks and driveways.


Install handrails on stairs and steps.


Keep floor dry, devoid of wet areas and greasy surfaces.


Keep walk areas clear of clutter, rocks and mud.


Install adequate lighting by doorways and along walkways leading to doors, 
gates.


Indoors
Ensure adequate lightning inside the house.


Remove unnecessary furniture and over crowding.


Keep floor dry and clean and devoid of wires, toys etc


Indicate steps, stairs by painting in contrasting colours.


If person has had a fall, he should get him self properly checked out by a 
physician to assess the risks of falling again and to ensure safety at home. 
When you go to see the doctor after a fall please remember to tell the doctor 
about all your current medications and medical conditions.


 

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