Understanding Falls Among the Elderly
Globally, falls are a significant concern, with 28-35% of individuals aged 65 and over experiencing a fall each year. This statistic rises to over 40% among those aged 70 and above. In India, falls impact 30% to 50% of adults over 60 years. These incidents often lead to fractures, trauma, and other injuries, necessitating hospital admissions and extensive rehabilitation.
Factors Contributing to Falls
- Age-related changes: Declining vision, hearing, and weakened muscles can lead to unsteady gaits.
- Chronic illnesses: Conditions like arthritis, osteoporosis, Parkinson's Disease, stroke, dementia, and diabetes increase fall risk.
- Medications: Drugs such as sedatives, antihistamines, and anti-depressants can impair coordination and balance.
- Psychological factors: Depression can cause inattentiveness and poor coordination.
- Environmental hazards: Poor lighting, slippery floors, and clutter contribute to falls.
Consequences and Emotional Impact
- After a fall, fear of recurrence can lead to restricted movement, decreased confidence, and social withdrawal.
- This emotional toll can exacerbate mental health issues like depression and anxiety.
Preventive Measures and Assessments
- Preventing falls requires proactive measures, including regular screenings and implementing elder-friendly designs in public places.
- Comprehensive reviews of chronic diseases and medications are essential.
Medication Review
- Check for high-risk medications that increase fall risk.
- Review polypharmacy: Taking more than four medications increases fall risk.
- Assess dosage and timing to minimize side effects.
- Monitor for postural hypotension to avoid dizziness and imbalance.
Functional Assessments
- Timed Up and Go Test (TUG): Screens for imbalance and gait disturbances.
- Muscle strength testing: Evaluates strength against resistance.
- Cognitive assessment: Assesses memory, attention, problem-solving, and judgement.
- Eye and ear assessments: Ensures vision and hearing are not contributing factors.
Promoting Safety and Rehabilitation
Improving balance, strength, flexibility, and body awareness are crucial in preventing falls. Public and home environments should adopt safety measures.
Home Safety Tips
- Flooring: Avoid slippery surfaces and ensure dry, clutter-free areas.
- Bathrooms: Use grab bars, anti-skid mats, and avoid climbing into bathtubs.
- Furnishings: Minimize clutter and ensure stability of walking aids.
- Lighting: Adequate and motion-sensor lighting helps prevent falls.
- Footwear: Use well-fitting, non-slip footwear.