Fall Prevention Research: The Bad News and the Good News
September 23 is National Falls Prevention Awareness Day.
The National Council on Aging sponsors this event, which is held on the first day of fall each year. This year's theme is "Strong Today, Falls Free Tomorrow," reflecting the role of fitness and overall health in the growing public health issue of falls and fall-related injuries in older adults.
A recent Caring Right at Home poll asked readers if they or an older loved one had experienced a fall injury during the previous year. More than a third of respondents reported that they or an older loved one had sought medical treatment for a fall-related injury; another third had been injured but not seriously enough to need a doctor. Clearly falls are an important issue for Caring Right at Home readers!
Bad news and good news in recent research
"A lot of older people don't recognize that falls can, in a flash, change their independent lifestyle,” says fall prevention expert Dr. Elizabeth Phelan of the University of Washington School of Nursing. In a publication of the Centers for Disease Control and Prevention (CDC), Dr. Phelan says, “Many older adults can no longer live on their own if they have suffered serious fall-related injuries.”
Fortunately, as the large baby boomer population is turning 65, more experts today are turning their attention to the problem of senior falls. Here are a few of the most recent findings.
First, the bad news, underscoring the severity of the problem …
Item: A sharp rise in the number of falls. The U.S. Census report highlighted in the top story of this issue of Caring Right at Home includes sobering statistics demonstrating the steep rise in senior falls, and the impact of falls on disability and loss of independence. Looking at data across a wide variety of sources, the report states that one-third of older adults fall each year; 2.2 million of those falls sent seniors to the emergency room, and a quarter of those were hospitalized. Seniors who experience repeated falls are much more likely to move to a nursing home. Falls also are a leading cause of death among older adults.
Item: Falls are now the No. 1 cause of spinal cord injuries. Until recently, automobile accidents were the top cause of these injuries. However, researchers from Johns Hopkins University School of Medicine recently announced that spinal cord injuries ranging in severity from temporary numbness to full-blown paralysis are now more likely to be fall-related. They report that airbags and seatbelts have cut down the rate of car crash-related spinal injuries; at the same time, our aging population means that more people are injured in falls. Says surgeon Dr. Shalini Selvarajah, "We have demonstrated how costly traumatic spinal cord injury is and how lethal and disabling it can be among older people. It's an area that is ripe for prevention."
Item: Fear of falling increases isolation in people with vision problems. A study from the Association for Research in Vision and Ophthalmology found that seniors who have age-related eye disease, such as macular degeneration, glaucoma and corneal dystrophy, tend to limit their activities because they are afraid they will fall. But this puts them at risk for social isolation, increased disability and shorter life. The team calls for interventions to help visually impaired seniors feel more confident about their abilities so they can remain both mobile and safe.
Now for the good news …
Item: When seniors fall, those who regularly exercise are less likely to sustain an injury. Gerontologists have long told us that an effective fall prevention exercise program makes it less likely that a senior will fall. But it is impossible to prevent all falls. However, reporting in the journal BMJ, French researcher Fabienne El Khoury showed that these exercise programs also appear to prevent injuries in the event of a fall. Her team reports, "Exercise seemed to significantly decrease the rate of falls resulting in medical care, serious injuries and fractures."
Item: Seniors can be motivated to lower their risk of falls. A team from St. Michael's Hospital in Toronto headed by epidemiologist Dr. Joanna Sale found that fracture patients who took part in a care and education program about falls wanted to do what it takes to reduce further falls. Said Dr. Sale, "Older patients who know they are at risk of fractures will make positive lifestyle changes to avoid them, such as exercising, wearing proper footwear and taking supplements." She reports that even though the patients said they would rather not think about the possibility of a future fracture, they were nonetheless motivated and willing to take steps such as using handrails, taking their medications and eating a healthy diet.
Item: Tai chi continues to get good marks for improving balance. As reported by the American Stroke Association, Dr. Ruth E. Taylor-Piliae of the University of Arizona College of Nursing says that stroke survivors experience seven times as many falls each year than do adults who have not had a stroke. Said Dr. Taylor-Piliae, "Learning how to find and maintain your balance after a stroke is a challenge. Tai chi is effective in improving both static and dynamic balance, which is important to prevent falls." Dr. Taylor-Piliae says that tai chi also helps improve strength, flexibility and aerobic endurance.
According to Dr. Phelan in the CDC report above, the psychological consequences of falls should not be underestimated. "People who fall may develop a fear of falling," she says. "And because of that, they may start limiting their activity, and that leads to what I call a vicious cycle or a downward spiral of worsening muscle weakness and an increased propensity for falls."
Give Yourself a Fall Prevention Checkup!
The studies above all show that older adults and their families should learn more about the risk of falls—and then use that knowledge to lower the risk. With all the things to remember, fall protection might seem like a daunting goal! To help you take steps to lower the risk, download a free, easy-to-use Fall Prevention Guide, created by Right at Home with Dr. Rein Tideiksaar, a leading expert on fall prevention for the elderly.