HEALTH: Preventing Falls Among Older Adults  



Dr. Mike Kern, John Muir Health


Did you know that falls are a leading cause of injury among older adults? According to the U.S. Centers for Disease Control and Prevention, “one-fourth of Americans aged 65+ falls each year.”


Falls, particularly among older people, are serious and frequently cause injury as people in this age group are often more fragile to begin with, magnifying any injury that occurs. When we’re young, we have the ability and resiliency to bounce-back quickly from minor spills or falls. Such is not the case as we get older, when even minor falls can cause significant injuries.


The patients I most commonly come into contact with who have experienced falls are older adults, primarily women, those with cognitive/balance problems, and those who have fallen before. While others are certainly prone to falling, these are the individuals I routinely see as high risk.


As you might imagine, there are a number of injuries an older person may sustain as a result of a fall. The most common is bruising and, more alarming and obviously debilitating, fractured hips. Other injuries we see as a result of older adults falling include leg and arm fractures, rib fractures, and head injuries. Death is rare, but not entirely uncommon.


There are a number of factors that can cause falls among older people including various medical conditions, medications, illness, lack of physical activity, home hazards such as slippery rugs or getting out of the tub or shower, and arthritis of the hip or knee which can certainly increase the chance of falling. Cognitive impairments such as a decline in one’s memory, motor or thinking skills may also place a person at greater risk for falling. Certain medications such as tranquilizers and high blood pressure medications can also increase the risk of falling.


Symptoms such as dizziness and/or lightheadedness, which can be brought on by a number of circumstances, can also lead to falling. Falls, however, can also be indicative of an underlying, more serious illness such as diabetes, Parkinson’s or even the presence of chronic musculoskeletal injuries. It’s a good idea to visit your doctor for a “fall screening” if you experience any of these symptoms.


Fortunately, there are some easy changes that older adults can make to help prevent falls. Simple things such as choice of footwear can make all the difference in the world. I recommend shoes with thin, hard soles for my patients. These types of soles provide stability, firmness and balance when walking. Running shoes are also quite popular among older folks for the comfort and firm grip they offer. I discourage patients from walking around in socks and bare feet, which tend to greatly increase the risk of slipping and falling.


Physical activity is also critical to keeping bones and joints strong and preventing falls. Physically active older adults are much less at risk for falls primarily because of their leg strength. When evaluating a person for risk of falling, we typically look at how long it takes the individual to get up from a seated position to walking. The longer it takes for someone to ‘get up and go’, the greater the risk he or she is for falling.


If one of my patients is identified as being at a higher than average risk for falls, I recommend lab tests that check for conditions which may increase the risk for falls.


The tests include those for hemoglobin, glucose, kidney function and vitamin D. If someone is deficient in vitamin D, for instance, treatment with supplements can go a long way towards improving his or her condition and decreasing their risk of a fall.


In addition, there are a number of preventative measures people can take to make their homes safe. High risk older adults should have their homes evaluated by an occupational therapist to ensure they are equipped with safety features such as rails, ramps and rubber-gripped bath/shower mats and any hazards, such as slippery throw rugs, are removed. An occupational therapist may even suggest walking/mobility devices and/or canes for added precaution.


I’m often asked when someone should consult their doctor about falls. I recommend that all older adults be screened for fall risk. People with vision or hearing problems or those who have fallen at least once, are particularly at risk and should be evaluated.


If you have been falling recently, experiencing balance problems or have other concerns, I encourage you to see your doctor immediately. Falls, and their underlying symptoms, are not something to take lightly. Stay healthy!


Dr. Mike Kern is a John Muir Health family doctor, practicing along with Dr. Elsa Tsutaoka.


Dr. Kern & Tsutaoka’s office is located at 3318 Elm St. in Oakland and open from 8:00 a.m. to 5:00 p.m. Monday, Wednesday, Thursday and Friday, as well as Tuesday evening and Saturday morning.


To schedule an appointment, call (510) 985-3620.


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