Fall Risk and Fall Prevention in the Elderly

Why is falling important?

“Falling” is used in medical terminology to express a person’s falls in situations where there is no strong external factor or loss of consciousness. Anyone can fall at any age, especially young children. But falls of children and teenagers usually do not cause serious problems. On the other hand, the risk of falls increases in the elderly, as well as injuries, fractures, traumatic brain injury from falls.it can even lead to death. A quarter of older people who break their hips die within the next 6 months. Falls are one of the leading causes of death in people over the age of 65. Even if it does not cause any injury, repetitive falls in the elderly may lead to the development of “fear of falling (post-fall anxiety syndrome)” and, accordingly, decrease in mobility and quality of life, and may lead to problems such as depression. People whose activity decreases due to the fear of falling have muscle wasting and the risk of falling again increases.

How can the risk of falling in the elderly be reduced?

It is recommended that people over the age of 70 should be questioned routinely by the physician in terms of falls. If there have been 2 or more falls in the last year, it is classified as “recurrent fall”. These people should be evaluated further in terms of falling. Muscle strength, balance and gait examination are performed and they are questioned in terms of risk factors for falling.

Read More  Fear of Falling in the Elderly

Factors at risk of falling

  • Advanced age is itself a risk factor.
  • Women are more likely to fall than men. However, men are at greater risk of fatal consequences from a fall.
  • Patients who have fallen before have an increased risk of falling again.
  • dementia
  • vision and hearing problems
  • Problems with the balance system
  • sedentary life
  • Less social interaction
  • Decreased muscle mass (sarcopenia)
  • Vitamin D deficiency
  • Neurological diseases such as Parkinson’s, stroke
  • Chronic diseases such as hypertension, COPD, kidney failure
  • Calcifications affecting joints such as hip and ankle (degenerative joint disease)
  • Use of drugs with side effects such as dizziness or drowsiness
  • Alcohol use
  • Irregularity of home and environment

Fall Prevention

  • Vitamin D deficiency can lead to muscle weakness and increase the risk of falls. Therefore, it is supplemented if it is missing.
  • If the person has a treatable visual impairment such as cataract, it is definitely treated.
  • His house is better lit, measures are taken for the threshold, carpet edge and slippery floors where his feet can be tripped. A high seat toilet is recommended. The risk of falling in the elderly can be reduced by adding bars to hold in the toilet and bathroom.
  • Physical activity is very important. Muscle strengthening and balance exercises, Tai chi exercises are useful in preventing falls.
  • Appropriate insoles and shoes are recommended for foot deformities due to joint calcification or inflammatory rheumatism.
  • Walking aids such as canes, canes, walkers, and rollators contribute to maintaining balance.
  • Some neurological and psychiatric drugs may be a cause of fall risk in the elderly. The drugs used by the person are reviewed and, in consultation with the relevant physician, they are replaced with drugs with less side effects, if possible.
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Prevention of Fractures

One of the most frightening consequences of falling for the elderly is hip fractures. 95% of hip fractures are the result of a fall. This is due to osteoporosis. Very small blows and light forces can cause fractures in people with osteoporosis. Bone resorption is detected by bone densitometry film (DXA). DXA examination should be performed for screening purposes in women over 65 years of age, even if they do not have any complaints. People with additional risk factors for osteoporosis may also need measurements at a younger age. Bone resorption can also be seen in men in advanced ages. If there is bone resorption, appropriate treatment is started. Thus, the risk of fracture can be reduced.

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