Each year, millions of adults ages 65 and older fall. In fact, more than 1 out of 4 older people falls each year, but less than half tell their doctor about it.
Dr. Jennifer Heffernan is medical director of the Baylor Scott & White geriatric section in North Texas. She talked with KERA’s Sam Baker about what leads to so many falls.
Dr. Heffernan: Normal changing in the body, such as muscles can become weaker. There can be other things like neuropathy, changes in the brain, arthritis, pain. Some of it is disease-related changes, and some of it is age-related changes.
Baker: Is there an age at which falling tends to become more of a problem?
Dr. Heffernan: We start screening for falls at 65. We know that the older somebody gets, the more at risk they are for falls. And so screening is the first step, asking questions about if the person has had any falls in the past, do they feel unsteady with walking?
Baker: One thing I read looking into this topic that said the single biggest risk factor for falls is a previous history of falling.
Dr. Heffernan: That is correct. A previous history of falling also can cause a fear of falling. And so if somebody has had a history of falls, we definitely want to be proactive in helping identify what their risk factors are and addressing specifically for that person what can improve their fall risk and help them be more mobile and also improve their independence and function.
Baker: The fear of falling leads to more falling. How exactly does that work?
Dr. Heffernan: Well, when somebody has a fear of falling, they may be more hesitant when walking. They may start avoiding certain activities. And so they might be sitting more. And we know the more that you sit or have a sedentary lifestyle, the weaker your muscles become. And then the more higher risk of falls you can have.
Baker: How dangerous can falls be for seniors?
Dr. Heffernan: Especially if there's an injury, it can be devastating. That injury can lead to further medical conditions that can end up in death, especially if they're is a hip fracture or if there is like any bleeding in the brain. Those are serious consequences of falls.
Baker: So what are steps that can be taken to avoid falling?
Dr. Heffernan: One is wearing sturdy shoes. Shoes that have strong arch support and heel support, good traction, but the sole's not too thick. You want to avoid wearing shoes that have a narrow heel or high heel, and avoid wearing shows that are slippery. And most falls occur in the person's own home. We really encourage our patients to wear their sturdy shoes in the home and outside the home. And avoid wearing socks or going barefoot when they're walking.
The other thing that I really focus on in my home visits is making sure the home is safe. Make sure there's clear pathways for people to walk, and that there's not clutter around. A lot of falls happen in the bathroom and bedroom. And so we want to make sure there's not a lot of clutter there.
Remove loose wires or electrical cords, make sure those are secure, and remove any loose rugs. If you have corners of rugs, put some double-sided tape on the corners to try to secure those.
Lights are actually really important to prevent falls, including like a night light in the bathroom at night.
Any movement is important, and we know that because if we're exercising, we know our muscles get stronger. And if we get sick, our muscles get weaker. So, the more movement we can include in our daily lives, that will really help decrease risk of falls also.
Baker: A posting from Mayo Clinic said if you're coming up with steps to avoid falling, make an appointment with your health care team?
Dr. Heffernan: Oh, yes, that is important, because on my list of things to address to prevent falls is a medication review, either with your health care team or your pharmacist.
A lot of medications for older adults can cause dizziness or sleepiness, and so you want to make sure your medications are working for you and not increasing your risk of falls. Not only prescription medications, but over-the-counter medications also can cause falls.
Medications that include diphenhydramine have been associated with not only falls, but cognitive impairment, constipation and dry mouth and dry eyes. And a lot of medications for allergy and sleep that our older patients are taking can contain diphenhydramine .
Baker: What kind of drug or product would you find that in?
Dr. Heffernan: A lot of sleep aids like Tylenol PM, Advil PM, Benadryl for allergies, those are some common brand names that have diphenhydramine in them.
RESOURCES:
Fall prevention: Simple tips to prevent falls
