Falls In The Elderly

Falls In The Elderly

According to the World Health Organization (WHO), people aged 65 years and above fall about 28%–35% every year, and this proportion increases as age and frailty levels increase.

Soft tissue injuries are common with falls. Falls are the leading cause of fatal injuries in the elderly. Bone fractures, especially of the hip and the wrist, and head injuries are some common fatal injuries. Subsequent hospital admissions lead to increased cost of care. Also, it increases the load on caregivers, and morbidity related to falls in the elderly is also high.

With aging, neuromuscular changes take place. Nerve conduction velocity decreases, reaction time increases, fast twitch muscle fibers decrease in number, loss of muscle fibers, and muscle strength decreases. These changes contribute to an increased risk of falls in the elderly.

Other predisposing factors include-

  • Neurological impairment-motor or sensory or mixed.
  • Dizziness 
  • An impaired vision such as glaucoma, cataracts, and visual acuity.
  • Altered depth proprioception
  • Immobility leading to deconditioning
  • Impaired gait/walking
  • Cognitive impairment
  • Vitamin D deficiency.
  • Environmental hazards- uneven floor, poor lighting, staircase without handrails, etc.
  • Polypharmacy 
  • Adverse drug effects such as anti-depressants and sedatives.

Falls are more common in the elderly living alone and those with walking issues.

The Timed Up and Go Test(to evaluate gait and balance) is a test to assess the risk of falls in the elderly.

Prevention of falls is possible by taking care of the predisposing factors. Strengthening exercises and weight-bearing exercises are good ways to reduce the effects of osteoporosis. Balance exercises also help in fall prevention. Get your vision checked regularly, and get yourself assessed and treated for any neurological sign or symptom. Medication review is also critical. Remove environmental hazards and create a safe environment. Thus a thorough home evaluation is necessary for fall prevention. Take necessary Vitamin D supplements if deficient.

Recurrent falls lead to morbidity and mortality. It also impacts functional independence and activities of daily living. Fear of falling is a significant psychological impact of falls in the elderly. As a result, they limit their mobility, making them weaker and more prone to falling. Recurrent falls should be critically evaluated for probable causes and managed accordingly.


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