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Falling is no laughing matter

By Anne R. Lindsay University of Nevada, Reno Extension

Extension offers tips on minimizing your risk of injury due to falls for September Fall Prevention Month

September is National Falls Prevention month, and with good reason. Falls are the number one cause of preventable injury-related deaths for those 65 and older, according to the Centers for Disease Control and Prevention.

Falls pose a significant threat not only to the health, but also to the independence of older Americans. In 2018, one out of three older adults sustained at least one fall. The number of older adults who died from falls, 32,000 or 88 each day, is expected to nearly double by 2030 (59,000 or 162 per day), as America’s baby boomer population ages. Over 10,000 people in the United States turn 65 every day. Falls are predicted to increase from 36 million to 52 million annually. The current estimated medical cost of falls to our health care system is $50 billion a year.

Falls often result in traumatic brain injuries or hip fractures and vary in severity. A mild fall can affect mobility and activities of daily living. Even without injury, older adults become afraid of falling, which increases their risk further and causes them to cut down on their everyday activities. Decreased activity makes the muscles weaker and increases the risk of falling (again).

While falling is not uncommon, it is also not a normal part of aging. Falls can be prevented. Here are some suggestions you might consider doing this month to decrease the chances of you or your loved ones being impacted by a fall:

• Talk about it. Talk openly with your family and your health care provider. Only 37% of older adults ask their health care provider about falls, and yet these professionals are very skilled at helping to assess fall risk and why that risk may be increasing. More than 90% of older adults see a doctor at least once a year, so that regular office visit is a good time to discuss if you have fallen within the past year, feel unsteady when walking or worry about falling.

• Take the Stay Independent Questionnaire. Before you go to the doctor, complete the CDC’s Stay Independent Questionnaire. Answer each of the 12 questions and total your score. Take the results to your next medical appointment so your healthcare provider can help create a personalized fall prevention plan if needed.

• Have your eyes, ears and feet checked. Conditions such as glaucoma and cataracts limit vision and increase chances of falling. Hearing loss can result in balance issues, causing you to be unstable. Foot conditions and improper footwear can also contribute to falls.

• Keep an updated list of all your medications and have it reviewed periodically. Four out of five older adults take at least one prescription medication each day, and more than one-third take five or more daily. While medications are taken to improve sleep, blood pressure, mental health or chronic pain, the side effects from these can result in a fall. Medications often change the way you feel or think, and each time your doctor prescribes a new medication it may increase your risk of falling. 

As you get older, not only do medications change, but also medicines change the way they affect your body (similar to food and drinks). Look for changes in vision, concentration, muscle strength, balance, reaction time, alertness, fainting, sleepiness or blood pressure. Ask your provider about taking vitamin D supplements to improve bone, muscle and nerve health.

Make your home safer:

• Minimize clutter and tripping hazards from stairs and places where you walk.

• Remove small rugs or use double-sided tape to secure them.

• Keep items you use often within easy reach (avoiding the need for stepping stools).

• Place grab bars inside and outside of the tub, shower or toilet area; use non-slip mats.

• Have handrails and lights installed on all staircases.

• Improve the lighting and have someone replace broken bulbs.

For additional ideas, review the Stopping Elderly Accidents, Deaths and Injuries or STEADI safety checklist.

Exercise to improve your balance, center of gravity and strength:

Unlike many animals who walk on all fours, we are “bipeds.” We walk upright, balanced on two legs with our center of gravity approximately located in the pelvis area. Balance of this center of gravity is important and can be disturbed both externally, such as by slipping and tripping due to an unsafe environment; or internally, such as by weak muscles and poor strength throwing off our balance and causing us to fall. 

Overall, women fall more than men, in part due to a greater lack of strength. Improving muscle strength, muscle mass, postural control, balance and coordination can prevent a fall or minimize its severity.

Despite knowing the benefits of physical activity related to chronic disease and physical function as we age, only 27% of older adults meet the recommended physical activity guidelines. The 2018 Physical Activity Guidelines for Americans Scientific Report provides strong evidence that physical activity reduces the risk of fall-related injuries in older adults by 32 to 40%, and that using various modes or combinations of physical activity provides the most benefits. Some examples of recommended activities include resistance or muscle strength training; cardio-endurance or aerobic activities, such as walking or dancing; and balance activities, such as Tai Chi, Pilates or Yoga. One or more combinations of these exercises will improve strength, balance, gait speed and ADLs.

If you are at low risk for falls and want to decrease your risk of falling later in life, try this simple chair exercise at home. This will strengthen your legs and buttocks through repeated standing and sitting. Activities such as this one may delay or reverse loss of independence by allowing you to continue your activities of daily living.

The CDC’s STEADI initiative website provides additional free materials, checklists and suggestions. The good news is, according to the CDC, receiving just a single fall intervention, such as medication management, home modification or an exercise program, could prevent falls. It is never too late to start.

Anne R. Lindsay is an associate professor and state specialist with University of Nevada, Reno Extension, a unit of the University’s College of Agriculture, Biotechnology & Natural Resources.