Injuries in the elderly are a common phenomenon, and the chief cause behind senior citizens suffering them are from falling. While a fall in a younger adult may not be that much of a concern, it can be dangerous and lead to severe problems, leaving older adults incapacitated for a long duration.

The natural process of ageing also contributes to older adults not being able to recover from such falls as bone, muscle and tissue do not repair as well, lowering the overall life expectancy as well as the quality of life.

The prevalence of falls among senior citizens is rather high around the world. A study published in the Indian Journal of Public Health in 2019 looking at these very phenomena in more than 2,000 people over the age of 60 years had a prevalence of nearly 25% due to various reasons.

A recent study published in the New England Journal of Medicine in July 2020 also reported a rate of 25.6 events per 100 person-years in the intervention group and a higher incidence of 28.6 events per 100 person-years in the control group. The study also found a similar rate of hospitalisation or death in both groups.

According to the Centers for Disease Control and Prevention (CDC) of the United States, more than one out of four people suffer from falls each year, which is in line with the Indian study as well. Another alarming statistic about the findings is that nearly half of those people do not inform their doctors about the fall.

Falling can occur due to various reasons, and any senior citizen who may have experienced a fall before has a higher likelihood of falling again, increasing the risk of severe injury.

  1. Why older people fall
  2. Complications of falls in the elderly
  3. Fall prevention in older adults
  4. Takeaways

There are several reasons why older people fall or are more at risk of falling. These are considered as risk factors among the elderly that make them susceptible to falling down:

  • Lack of balance in the body, especially while walking
  • Poor or reduced vision
  • Poor choice of footwear or pain in the feet due to the footwear
  • Weakness in the lower half of the body, due to muscle stiffness or reduced muscle strength (Read more: Muscle pain)
  • Chronic conditions such as arthritis, diabetes or stroke also increase the chances of suffering from falls
  • Increased use of medicines, such as sedatives or antidepressants
  • Low vitamin D in the body (Read more: Vitamin D deficiency)
  • External factors, including broken paths, steps, slippery or wet surfaces, things lying in the way
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Falls are one of the leading causes of injuries—both fatal and non-fatal—among people over 65 years of age, according to the CDC. Some of the complications of falls include:

  • Broken bones in the arms, hands, legs, feet and hip: According to the CDC, about three million senior citizens in the US visit the emergency room due to falls, while more than 800,000 of them are hospitalised, with injuries to the head or hip fractures being the common causes.
  • Head injuries: Head injuries can lead to hospitalisation. They can even be fatal. Falls are the most common reason behind traumatic brain injuries among the elderly.
  • Fear of falling: A person who has fallen in the past may become wary of falling down again. They may reduce their daily activities such as regular walks, as a result. Ironically, this non-activity increases muscle weakness and the chances of falling again.

To ensure good quality of life in old age, preventing falls and accidents is very important as they can seriously affect the daily life of the elderly. Here are a few tips to help you achieve this:

  • Visit your doctor for advice: Any general physician, or a specialist whom an elderly person may have been seeing already for a chronic ailment, can help by making some recommendations regarding lifestyle. The doctor may take stock of the medications being given to the person to see the side-effects—like slower or delayed reactions. A change in medication in these cases can help in preventing falls, especially if there are sedatives or antidepressants in the prescribed list of drugs.
    The doctor will also ask about the patient's medical history and experiences with falls, if they have suffered any before, and the resulting injuries they suffered. The patient may also be required to explain instances when they came close to falling but were saved by someone else. Underlying health conditions can also be culprits behind falls, especially if one feels dizzy after getting up, is breathless while walking or has muscle or joint pain. The doctor may suggest some corrective measures and treatments.
  • Increase physical activity: Instances of falling are sometimes also related to inactivity. Based on a health evaluation, the doctor may also prescribe mild forms of exercises to build strength in the joints and muscles of the body. These exercises can include simple long walks in the park, practising simple yoga postures or seated, strength-building exercises. The doctor may also refer them to physiotherapists who can help with some specific movements and exercises to improve the body's strength, flexibility and overall balance.
  • Keep the home clutter-free: Unnecessary things such as large boxes, computer or television wires lying around in the house can be hazardous for the elderly. The home must also be free of too many pieces of furniture to make it easy for the person to walk around indoors as well. Anything coming in the way of a normal path for an older person must be removed and kept in a safe place, to prevent falls. Bathroom floors should be kept dry. Using anti-slip mats and grab rails along the walls is also a good idea.
    Staircases must be well-lit and have even, pronounced steps to be able to climb up and down easily, with well-supported railings, while balconies and gardens must also be kept clear of things strewn around.
  • Pick comfortable footwear: Comfortable, closed walking shoes must be part of an older person's wardrobe, along with comfortable, non-slip slippers to be worn at home. Shoes and footwear are also critical in easing pain in the joints in the lower half of the body.
  • Install supporting devices at home: From grab rails to anti-skid mats or tiles in the bathrooms and sturdy toilet seats, the house must be equipped with things to hold on to for older people. Staircases and rooms must be well lit and well maintained to avoid unnecessary falls.
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It is well established that falls are a common cause of serious injuries among the elderly. Further, serious injuries from falls can adversely affect the quality of life as well as longevity.

If you are over 65, you can reduce your risk of falling by notifying a doctor when you take a tumble—it's true that all of us lose our footing once in a while, but you can ask your doctor questions like:

  • Whether any of your medicines could be making you dizzy
  • Whether any of your health conditions, say, arthritis, could be affecting your balance
  • Whether loss of muscle tone or nutritional deficiencies may be the reason you are more prone to falling now

For each of these, your doctor could suggest fixes like another medicine option, suitable shoes and exercises and dietary changes, respectively.

Your doctor may ask you some questions to assess what makes you more vulnerable to falls. They can then advise you to create an atmosphere where such incidences can be prevented in the long run, ensuring a pain-free, peaceful life.

Remember also that your metabolism isn't what it used to be, so try to minimise alcohol consumption.

You could also work with an occupational therapist who can advise you on the best ways to organise your life and space to minimise falls.

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