Falls in the Elderly
Accidents and/or the environment accounted for at least 30% of falls according to Laurence Rubenstein in a 2006 article in Age and Ageing. Other causes include:
- Accident’/environment-related 31%
- Gait/balance disorders or weakness 17%
- Dizziness/vertigo 13%
- Drop attack 9%Confusion 5 %
- Postural hypotension 3%
- Visual disorder 2%
- Syncope 0.3%
- Other specified causesd 15%
- Unknown 5%
Any falls attributed to accidents really stem from the interaction between identifiable environmental hazards and increased individual susceptibility to hazards from accumulated effects of age and disease.
A number of studies were reviewed by the Rubenstein and the following risk factors were found:
- Weakness
- Balance deficit
- Gait deficit
- Visual deficit
- Mobility limitation
- Cognitive impairment
- Impaired functional status
- Postural hypotension
Mike Wyndham in his 2010 article, Falls and syncope in the elderly, concludes there are a wide range of physical causes that may be extrinsic (ie unsafe environments and polypharmacy) or intrinsic (ie physical illness). They may result in a loss of confidence and independence and lead to social isolation. Morbidity from falls can be significant and ultimately lead to death.
Costello and Edelstein reviewed a number of intervention programs for fall prvention in 2008. The review yielded 4 key points:
· Multifactorial falls prevention programs appear to be more effective for individuals with a previous history of falls.
· Medication and vision assessment with appropriate health practitioner referral should be included as part of a falls screening examination.
· Exercise alone is effective in reducing the number of falls. It should include a comprehensive program combining strengthening, balance, and/or endurance training for a minimum of 12 weeks.
· Home hazard assessment with modifications may be beneficial in reducing falls, especially in a targeted group of individuals. Additional benefits may be obtained if an OT or a PT conducts the assessment
Sources
Wyndham, M. (2010). Falls and syncope in the elderly. Practice Nurse, 40(9), 31-35.
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