How Older Adults Can Avoid Falls

Falls are a major risk for older adults. About one in four adults 65 and older report falling. Every year, fall injuries send 3 million people in that age group to emergency departments and cause tens of thousands of deaths.

Older adults are at risk for many reasons: medications, health problems, poor vision, household hazards, balance issues and loss of muscle mass all can contribute to fall risk. Most falls are caused by multiple risk factors.

But it’s important to remember that falling as you get older is not inevitable. Falls can be prevented.

Older patients and their doctors should discuss the issue, says University Hospitals internal medicine physician Divya Sree Madhuramthakam, MD.

Risk Factors for Falls

Your doctor will screen for fall risk based on numerous factors:

• History of falls.
• Current medications.
• Chronic health conditions such as heart disease, arthritis, Parkinson’s and dementia, which increase risk.
• Gait and balance problems.
• Muscle weakness.
• Numbness in the feet or legs.
• Postural hypotension, which is a drop in blood pressure when you stand up. It can be caused by cardiovascular disease, medications (including diuretics, antidepressants and blood pressure drugs) neurological conditions, anemia or Vitamin B12 deficiency.
• Vision problems.
• Hazards in the home.

“A physical exam should include a get-up-and-go test,” Dr. Madhuramthakam says. “We ask the patient to get up from a chair and walk to a wall, turn around, walk back to the chair and sit. We measure the time it takes, if they have any balance issues, if they have issues with pacing and if they’re able to turn around without staggering.”

How to Prevent Falls

Exercise is one of the best things older adults can do to reduce the risk of falls, Dr. Madhuramthakam says. Strength and balance exercises and gentle aerobic exercise such as waking and tai chi will make your muscles stronger and improve coordination and flexibility.

Other important prevention strategies include:

• Annual medical and vision checkups. Make sure your feet are checked – people with diabetes especially – because nerve or circulation problems in the feet and legs can cause numbness.
• Have your doctor check your medications and make adjustments if necessary.
• A blood test will show if you have a vitamin B12 deficiency, which can be corrected with injections or supplements, depending on the severity.

You can also make some changes at home to reduce the risk of falls:

• Install railings, grab bars and similar assistive devices. Hand-railings on stairs are essential.
• Do a safety check and eliminate risks such as loose rugs, cords or clutter in high-traffic areas.
• Make sure lighting is bright and stairways are well lit.
• Avoid step ladders, stools and standing on chairs to reach things. Place frequently used things within reach.
• Wear properly fitted, sturdy shoes with non-skid soles.
• Use non-slip mats in the bathtub or shower. Bath seats and raised toilet seats are also an option.
• Turn on lights if you get up at night. Don’t walk in the dark.

“It’s a multi-pronged approach,” Dr. Madhuramthakam says. “It’s muscle strength, medications, exercise, foot health and vision. It’s making sure home is a safe place.”

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Whatever your age or stage of life, prevention is the best medicine. That's why it's important to see your primary care provider for age-appropriate screenings and vaccinations that can prevent disease.