Why are falls common in older people?
Age-related changes in muscle strength, balance, vision, reaction time and joint mobility can increase fall risk. Parkinson’s disease, stroke, arthritis, diabetes-related nerve problems, postural hypotension, dizziness, certain medicines, unsafe footwear and hazards at home may also contribute.
Are falls a normal part of ageing?
No. Falls are not inevitable. Risk can often be reduced by treating contributing health problems, improving strength and balance, reviewing medicines, addressing vision or hearing difficulties, and making the home safer.
Does footwear make a difference?
Yes. Choose well-fitting footwear with secure fastening, a stable low heel and non-slip soles. Avoid loose slippers, worn soles, unstable or high heels, and walking barefoot on slippery surfaces. Walking aids should be correctly checked regularly. A qualified healthcare professional should assess height and use of a walking aid when
necessary
How can the home be made safer?
Remove loose rugs, trailing wires and clutter. Improve lighting and add night lights. Install secure grab bars near toilets and in bathrooms. Use non-slip surfaces and a stable shower seat when appropriate. Install stair handrails, preferably on both sides when feasible. Keep frequently used items within easy reach. Avoid using stools or chairs to reach high shelves. Keep walking paths clear. Consider a professional home-safety assessment after a fall or when mobility is limited.
Why might blood pressure be checked while standing?
Orthostatic hypotension is a fall in blood pressure after standing. It may cause dizziness, blurred vision, weakness, unsteadiness or fainting. A healthcare professional may check blood pressure while sitting or lying down and again after standing when symptoms or medical risks are present. Rise slowly and sit at the edge of the bed briefly before standing. Adequate hydration may help some people, but fluid advice must be
Which exercises help prevent falls?
Exercises that challenge balance and improve leg strength and everyday function are particularly helpful. Examples include:
Sit-to-stand exercises from a sturdy chair. Heel raises while holding firm support. Supported balance exercises. Step-ups when appropriate and safe. Walking according to ability. Tai chi or structured falls-prevention programmes.
How much exercise should an older person do?
If medically appropriate, gradually work towards 150 minutes of moderate-intensity activity each week, together with muscle-strengthening activities on at least two days. Walking is beneficial for general health but is usually not enough by itself to prevent falls; balance, strength and functional exercises are also important. Frail or inactive people should start with manageable sessions and progress slowly.
Who is at greatest risk of falling?
Risk is higher after a previous fall or when a person has walking or balance problems, dizziness on standing, vision impairment, frailty, muscle weakness, cognitive impairment or takes multiple medicines. Osteoporosis does not usually increase the likelihood of falling, but it increases the risk of a serious fracture if a fall occurs.
Can medicines increase the risk of falls?
Yes. Sleeping tablets, sedatives, some antidepressants, opioids and other medicines that cause drowsiness, dizziness or poor coordination may increase fall risk. Blood-pressure medicines may contribute if they cause symptomatic low blood pressure. Diabetes medicines may increase risk if they cause low blood glucose.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.
