What older people can do to prevent falls
Falls can happen at any age. But because a fall can have serious health consequences, it's especially worthwhile for older people to prevent falls as much as possible. Also, some of the ways that falls can be prevented are quite simple indeed.
One simple and effective measure is to eliminate hazards around the house. For people who are living at home and are at greater risk of falling it can be a good idea to identify hazards in their living area and entryway, and have them removed. This appears to be most successful when done together with a trained professional, such as an occupational therapist. It's also an especially good idea to get rid of hazards for people who have impaired eyesight.
Can exercise programs help?
An age-appropriate exercise program can help people who live at home and who are a greater risk of falling to strengthen their muscles and improve their balance. Research shows that those kinds of programs can prevent falls. Group programs and individual home training are both effective. But it's essential that you choose exercises that are suited to your own physical abilities.
Older people who live in nursing homes usually have more health problems than those who don't. But even for them, a training program could be beneficial. Studies show that even more severely impaired people in nursing homes fall less often if they've been offered an individually tailored training program for avoiding falls. These kinds of programs are usually given by specialists from various fields, such as physiotherapy or geriatric care. A team of experts from different disciplines can recognize individual risks more readily and better adapt the measures to an individual’s needs.
Can discontinuing the use of certain medications lower your risk of falling?
Some medications can increase the risk of falling either when taken by themselves or in combination with other drugs. Studies show that the risk of falling is lowered when the unnecessary use of medication is stopped. The first step is to list all of the medication being used. Then you can talk with a doctor about whether you really need to take all of the medications and whether drug interactions could occur.
Some psychotropic medications are known to increase the risk of falling. People who have symptoms such as severe restlessness, sleeplessness, anxiety or fatigue sometimes turn to these types of medications, such as benzodiazepines. Stopping the use of these medicines step by step can lower the risk of falling. Because dependency on benzodiazepines can start after just a few weeks at a low dose, it's not always easy to stop using it.
Can vitamin D prevent falls?
Current research suggests that vitamin D can help to avoid falls in people who have low levels of vitamin D. Vitamin D doesn't have any effect in people who already have normal levels of vitamin D. A blood test is used to determine vitamin D levels.
Vitamin D is believed to strengthen muscles, and it also promotes the absorption of calcium and phosphate from the bowel. Having enough calcium in the body is important for normal bone metabolism and, as a result, bone stability. Vitamin D might be more effective when taken together with calcium.
Vitamin D and calcium can have adverse effects. These particularly include the development of kidney stones. European and U.S. authorities recommend taking not more than between 1,000 and 1,300 mg of calcium in the form of dietary supplements a day.
What can people with certain health problems do?
Some studies also show that people can lower their risk of falling by getting treatment for certain health problems:
- People who have cataracts can lower their risk of falling by having the cloudy lenses surgically removed and replaced by artificial lenses to improve their eyesight.
- Getting a pacemaker could be a good idea for some arrhythmias (irregular heartbeat).
- People who have problems with their feet can prevent falls by using inlays or doing foot and ankle exercises.
What else might help?
In some studies doctors, nurses, physiotherapists and occupational therapists analyzed the individual risk of falling for older people and then recommended preventative measures based on their findings. They checked, for instance, whether the participants had vision or other health problems that would increase the risk of falling, and whether they could benefit from wearing glasses or using a walker. These individualized interventions proved helpful.
In winter, wearing spikes or “snow chains” on your shoes could reduce the risk of falling outdoors. These chains are fixed around the sole of the shoe and are intended to prevent you from slipping in icy conditions, much as conventional snow chains do for cars. In one study this strategy helped to prevent falls.
Even though there is a lot you can do to prevent falls, not every fall can be avoided. That is why it's important especially for older people and people with osteoporosis to know how they can strengthen their bones to protect themselves.
Cameron ID, Gillespie LD, Robertson MC, Murray GR, Hill KD, Cumming RG et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2012; (12): CD005465.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012; (9): CD007146.
Lee SH, Kim HS. Exercise Interventions for Preventing Falls Among Older People in Care Facilities: A Meta-Analysis. Worldviews Evid Based Nurs 2016; 14(1): 74-80.
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med 04.10.2016 [Epub ahead of print].
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