Falls and Fall Prevention

The key is to remain as active as safely possible

Statistics from the CDC website

• Every year, one out of every four older adults will fall in the US. This equals 36 million falls and results in 32,000 deaths, according to the CDC.
• The CDC also reports that one out of every five falls causes an injury, such as a broken bone or a head injury. Falls are the most common cause of injury in older adults.
• Falls cause more than 300,000 hip fractures annually according to the CDC.
• Medical costs for falls are over $50 billion, in one year alone.
• The number of falls and injuries due to falls will increase as the older population grows.

Let’s be clear, even falls that do not result in injury can have serious consequences. Psychological trauma and fear or anxiety of falling produce a downward spiral of self-imposed activity reduction. This leads to loss of strength, flexibility, and mobility, thereby increasing the risk of future falls. People will become less active and make their world smaller thinking this will help them not fall again, but ironically, this increases their risk of falling again. It is very important for people who fall to remain as active as safely possible.

Falls are not a normal part of aging and many of them can be prevented. Current research indicates that elderly fallers are different than their healthy, age-matched counterparts. Some have medical diagnoses such as diabetes, osteoporosis, or Parkinson’s Disease that contribute to falling, but many have no diagnoses that explain their falls. This is because they do not have one large problem within a single system that would “earn” them a diagnosis. Instead, they often have many small problems across systems that interact to produce instability. Each of these small problems is a risk factor for falls. Individually, none of these factors may cause a fall, but in combination, they can. The more risk factors a person has the greater the likelihood that they will fall.

Risk Factors for falls

• Excessive postural sway when trying to hold still. Can the older adult remain stable when standing if their feet are close together?
• Restricted limits of stability. Can the individual move safely, quickly, and smoothly?
• Inability to survive balance disturbances. Can they survive predictable and unpredictable perturbations?
• Unsteady starting and stopping their walking and loss of balance during turns.
• Decreased strength and flexibility, especially lower body weakness.
• Conditions of the feet such as corns, calluses, bunions, arthritis, and toenail problems. Poor footwear.
• Poor judgment, decreased cognitive ability, depression, and social isolation.
• Medication use and interactions.
• Vision and hearing problems.
• Incontinence and rushing to the bathroom.
• History of vertigo/dizziness/light-headedness.
• History of falls.
• Vitamin D deficiency.
• Increasing age.
• Environmental risk factors include poor lighting, stairs without railings, clutter, loose throw rugs, and wet and slippery surfaces.

The CDC and the American Geriatric Society recommend yearly fall assessment screening for all adults 65 years of age and older. People need to talk openly with their doctor about any falls, near falls, or symptoms and discuss ways to prevent falls. There are several tests your physician or physical therapist can perform to test your strength, mobility, and balance to determine your risk level for falls.

Interventions for fall prevention

1. Strengthening exercises, especially for the legs.
2. Balance exercises and programs such as Tai Chi.
3. Enroll in a Fall Reduction Program.
4. Maintain a walking program.
5. Discuss all medications with your doctor.
6. Request Vitamin D levels be checked for deficiency.
7. Have your eyes and ears checked by your doctor and follow up with any treatments.
8. Do a Home Safety Checklist – such as 40 Home Safety Tips for Fall Prevention and make the changes to reduce fall risks.
9. Should you use a walking device such as the Giraffe Rolling Cane or a walker to help with stability?
10. A referral to physical therapy may be appropriate.

In closing, it is important to talk with your doctor about preventing falls. There may be physical or medical reasons contributing to your fall risk. There may also be environmental risk factors that you can change to reduce your risk for falls. One of the key factors to reducing your fall risk is to stay active and do exercises that make your legs stronger and improve your balance.

Please consult with your physician or licensed medical professional for questions and more information. 

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Also, read the Ultimate Guide to the Giraffe Rolling Cane