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Thomas S. May, M.A.Medical Writer |
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How to Keep Seniors From Falling: Tests, Tips
Thomas S. May, Medical Writer
Introduction Adele Burstein is a youthful-looking widow in her early 70s. She is fairly healthy, aside from needing a walker to get around the nursing home where she lives. Her children decided to put her in the home 2 years ago after she broke her hip in a fall and was no longer able to look after herself. She didn't admit it at the time, but it was her third fall in less than a year.
Adele is one of nearly 400,000 US seniors who die or suffer serious injury each year because of a fall. According to recent statistics assembled by the US Centers for Disease Control and Prevention (CDC), falling is the leading national cause of accidental death and disability in people over 65: Three out of ten seniors report at least one significant fall each year.
Many of these falls could be prevented if those who are at high risk were identified beforehand, according to Horst R. Konrad, MD, who specializes in age-related falling and balance disorders. He says that identification is not easy, however, because most falls have many contributing causes. Fortunately, there are some easy tests that can help identify seniors who are at high risk for taking a bad tumble.
Falling Factors Here are the most common reasons elderly people fall:
"There are some very simple, easy-to-do tests that can be done for screening," says Marian Girardi, MA, director of the vestibular clinic at Southern Illinois University (SIU) Medical School. Perhaps the simplest one, she says, is the "timed get-up-and-go test," which measures how long it takes for a person to get out of a chair, walk 3 meters, turn around, return to the chair, and sit back down. Other simple tests include the Tinetti and Berg scales, which look at gait and balance--the way you stand and how you walk. According to Girardi they are somewhat subjective, but there are also more objective tests--for instance, computerized dynamic posturography--that use computers to measure a person's ability to keep their balance in different situations.
Preventing Falls In a recent study, Girardi and her colleagues at SIU Medical School looked at how well some of these tests could predict the risk of falling in a group of 36 elderly persons. The researchers found that there was high agreement among all of the tests, "so doing any one of them is a good way to find out which elderly people are at high risk for falling." Primary care physicians should routinely ask their elderly patients whether they had any falls in the past, say geriatric specialists. "If you don't ask, you're not going to get the information," Konrad says. He adds that if patients report any falls, they should be screened for the presence of any balance disorders. Screening should also be done even if there is no history of falling but the patient complains of dizziness or a fear of falling. Shelley Sternberg, MD, a geriatric specialist at the University of Chicago, agrees that all seniors should be asked about falls. "Elderly people who have had falls in the past or have some other risk factors such as muscle weakness or visual problems should have a more focused evaluation [of their risk of falling], and they should be assessed using standard gait and balance tests," she says. Since elderly people can fall for many different reasons, prevention must be individually tailored to each patient, according to Sternberg. For example, people with weak thigh muscles might do exercises that are designed to strengthen their quadriceps: "They could be sitting on a chair, put 1-pound weights on each ankle, straighten their knee, hold for 10 seconds, bend again, and repeat ten times." Seniors with weak or painful leg joints should be given a prescription for appropriate gait aids such as a cane or a walker. "They should also wear good shoes that are supportive around the ankle but whose soles are not too thick," Sternberg says.
Make Home Safer Besides the steps targeted to individual needs, experts also recommend some general preventive measures for older people who are at increased risk of falling. Tai Chi, for example, can be particularly helpful, according to Ge Wu, PhD, of the Department of Physical Therapy at the University of Vermont. "It has been shown that long-term practice of Tai Chi can lead to a reduction in the number of falls and, most importantly, can help reduce the fear of falling in the elderly population." Other general preventive measures focus on making the home environment--where most falls happen--safer. These include
Thomas S. May is a medical
journalist based in Toronto, Ontario, Canada. He has a master's degree in
psychology from Simon Fraser University in Burnaby, British Columbia. Source: Medscape Health
Reprinted from Medscape Health for Consumers.
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