Over last few months I have encountered falls in people who I know closely. Being a GP, it is something I often see in professional life as well.
Falls can be a leading cause of disability after the age of 65. Statistics show that one out of five falls lead to further long term damage in the form of head injury or fractures (1). Falls are not natural part of ageing and most can be prevented by looking after lifestyle choices which can be improved at any age.
I wanted to share some simple measures which can be used to prevent falls.
Balance and strength exercises are very simple exercises which can be done holding on to the kitchen counter or a chair. They can be done in the comfort of your home but overtime they can reduce the risk of falling as muscle strength and balance improves. I have added a link to a video should you want to make a start (2). If you wanted other exercises my advice would be look at OTAGO balance exercises on google and choose whichever videos you like.
Improve muscle strength not just for the lower body but also for the upper body. Doing some simple exercises 2-3 times a week can be helpful. I have attached a link in the references (3). If you are able to do these and still keen, you could add some very light weights too. I have added this separately as most people do walking or look after the balance and strength exercises involving the lower body. I could not stress enough that in the event that one falls, upper body strength is very much needed to get back up.
Have a healthy diet which is rich in anti-inflammatory food consisting of lots of fruits and vegetables. Make sure there is a portion of protein in each meal as this is the building block for the muscles. As we age there is a loss of skeletal muscles and studies show that there is a 50% decline by the 8th decade (4). This can be improved by regular exercise and healthy intake of a balanced diet. It is important to make sure the diet has enough calcium on a regular basis. There is no need for supplements unless your doctor has specifically advised as calcium intake can easily be met with dietary options. I have added a link to evidenced based factsheet which has many tips about looking after bone health with plant-based options of foods rich in calcium (5).
Vitamin D is again very important in maintaining overall health but even more so when it comes to looking after the muscles and bones. 1000-2000 IU per day is the recommended amount for an adult.
Keeping an eye on medication is an important part when discussing falls. Often people over the age of 65 are on several medications. These need to be reviewed regularly with your health professional. There is risk of blood pressure becoming low in old age, specifically when suddenly standing or sitting from a lying down posture. This can present in the form of dizziness or feeling faint or loosing balance. It is called postural hypotension and important to be discussed with a health professional. (Please do not stop any medication without any professional guidance. This blog is to spread the information but personalised approach would be needed when it comes to medication.) Some medication like painkillers and sedatives come with added side effects of causing dizziness and affecting balance, which can then increase the risk of falls.
Visit the optician and make sure that vision is maintained at its best. For those who use glasses, regular visits would be important but making sure the spectacles are in good condition is vital when preventing falls.
Looking after hearing is often overlooked and if this is a concern, checking and investing in hearing aids can reduce not only the risk of falls but risk of dementia too.
Keeping the feet in healthy condition is essential. I often see in my own patients that corns, callouses or bunions are ignored as being part of the ageing process. However, these insignificant small lesions can affect balance and how we are walking. Making sure that footwear is in the best condition and fitting comfortably and securely is crucial. This needs attention not just for outdoor footwear but indoors too.
My final advice would be about making the home environment safe. Little things like not having enough light, loose wires lying here and there, slippery floors and rugs and carpets are only few of the common culprits that lead to falls in the over 65s. Simple checks like making sure the bathroom is safe and not slippery can go a long way. I have added a link which explains simple tips about fall proofing your home (6). People who have pets should be more aware of where their pet is lying as this can be a common reason to tip the balance.
This blog would not be complete without mentioning reduction of alcohol for obvious reasons.
My elderly patients always say they want to live independently as long as possible. Falls can be a big reason to make this difficult and hence starting sooner rather than later would be my advice.
I am hoping that this blog gives you some ideas to take simple measures to reduce the risk of falls. I will certainly be sharing it with many of my loved ones and patients.
References and resources:
- https://www.cdc.gov/mmwr/volumes/69/wr/mm6927a5.htm
- https://www.youtube.com/watch?v=s-3198ceK8M
- https://www.youtube.com/watch?v=DTkQlC9q2mM
- https://pubmed.ncbi.nlm.nih.gov/22955023/
- https://plantbasedhealthprofessionals.com/wp-content/uploads/BoneHealthPatients-210222.pdf
- https://ukcareguide.co.uk/10-top-tips-on-fall-proofing-your-home/
