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FALL Prevention!

FALL has arrived!  And with it comes some FALL prevention knowledge.  Learn about falling facts, risk factors, and simple preventative measures below:

Facts:

  • 1/3 of older adults fall at least one time per year. 1
  • 1 out of 5 falls lead to serious injury (fractures, head injury). 2, 3
  • 2.8 million older adults are treated in the ER for fall injuries each year. 4
  • 800,000 people a year are hospitalized for injuries (hip fracture, head trauma) due to a fall. 4
  • Falls are the most common cause of traumatic brain injury (TBI). 5
  • More than 95% of hip fractures are caused by falling. 6
  • Even if a fall doesn’t result in an injury, falling can lead to avoiding activity and social events.  This can lead to decreased muscle strength, increased fear of falling, and depression, which can further increase the chance for falling. 7, 8

Risk Factors:

  • Muscle weakness (especially gluteal and calf muscles!) 9
  • Postural hypotension 10
  • Vestibular disorder/ Poor balance 11
  • Decreased foot sensation 11
  • Vision impairments 12
  • Foot pain or poor shoe wear 10
  • Medications (polypharmacy) 13
  • Deconditioning from inactivity 12
  • Depression 14
  • Environmental/ home hazards (uneven steps, throw rugs, clutter, pets, poor lighting, no handrails) 15

 

Ways to Prevent Falls:

  • See a physical therapist for a full evaluation of risk for falling and perform STRENGTH and BALANCE exercises.
  • Wear supportive shoes.
  • Use an assistive device when walking (walker, cane) to increase your stability.
  • Get your eyes checked regularly.
  • Home Environment Safety:
    • Clean up the clutter!
    • Throw away throw rugs.
    • Add grab bars near the shower and toilet.
    • Install railings for the stairs.
    • Add lighting (lamps or night lights).

Resources:  http://stopfalls.org/coalitions-networks/fp-coalition-information/

 

1. Stevens JA . Falls among older adults—risk factors and prevention strategies. Falls Free: Promoting a National Falls Prevention Action Plan. Washington, DC : The National Council on the Aging ; 2005.

2. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hopitalization for fall-related injuries in older adults. American Journal of Public Health. 1993;82(7):1020-3.

3. Sterling DA, O’Conner JA, Bonadies J. Geriatric falls: injury severeity is high and disproportionate to mechanism. Journal of Trauma-Injury, Infection and Critical Care 2001;50(1):116-9.

4. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed October 11, 2017.

5. Jager TE, Weiss HB, Coben JH, Pepe PE. Traumatic brain injuries evaluated in U.S. emergency departments, 1992-1994. Academic Emergency Medicine, 2000;359;7(2):134-40.

6. Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 1993;52:192-98.

7. Denkinger MD, Lukas A, Nikolaus T, Hauer K . Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review . Am J Geriatr Psychiatry. 2014 ; 23 ( 1 ):72-86 .

8. Allison LK, Painter JA, Emory A , et al. Participation restriction , not fear of falling , predicts actual balance and mobility abilities in rural community dwelling older adults . J Geriatr Phys Ther. 2013 ; 36 ( 1 ): 13-23 .

9. Daly RM, Rosengren BE, Alwis G , et al. Gender specifi c age-related changes in bone density, muscle strengthand functional performance in the elderly: a-10 year prospective population-based study. BMC Geriatr. 2013; 13 ( 1 ): 71 .

10. Kabeshova A, Annweiler C, Fantino B , et al. A regression tree for identifying combinations of fall risk factors associated to recurrent falling : a cross-sectional elderly population-based study . Aging Clin Exp Res. 2014 ; 26 ( 3 ): 331-336.

11. Cohen RG, Nutt JG, Horak FB . Errors in postural preparation lead to increased choice reaction times for step initiation in older adults . J Gerontol Biol Sci Med Sci. 2011 ; 66A ( 6 ): 705-713.

12. Dhital A, Pey T, Stanford MR . Visual loss and falls: a review. Eye. 2010 ; 24 ( 10 ): 1437-1446 .

13. Freeland KN, Thompson AN, Zhao Y , et al. Medication use and associated risk of falling in a geriatric outpatient population . Ann Pharmacother.2012 ; 46 ( 9 ): 1188-1192 .

14. Quach L, Yang FM, Berry SD, et al. Depression, antidepressants, and falls among community-dwelling elderly people: the MOBILIZE Boston study . J Gerontol Biol Sci Med Sci. 2013; 68 ( 12 ): 1575-1581 .

15. Letts L, Moreland J, Richardson J , et al. The physical environmentals a fall risk factor in older adults: systematic review and meta-analysis of cross-sectional and cohort studies . Australian Occup Ther J. 2010 ; 57 ( 1 ): 51-64 . 

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