What Causes Falls in the Elderly?
Every year in the UK, a third of people over the age of 65 fall at least once1, which means that in this year alone, at least 4 million people will experience a fall.
Aside from physical injuries, the mental and emotional consequences of a fall are serious. A survey commissioned by Age UK found that millions of older people are worried about falling over, with 4.3 million (36%) saying it topped their list of concerns2.
Why do older people have more falls?
What causes older adults to fall? At a very simple level, falls occur because of a loss of balance. The processes that enable a toddler to stand and walk are the first to break down in the elderly, which increases their risk of losing balance and falling.
At a recent Felgains webinar, “Falls Pathways: How can we Prevent the Revolving Door?”, we heard from Dr David Shipway, Consultant Physician & Geriatrician at North Bristol NHS Trust, who covered in detail why and how elderly people fall, and why people are more likely to fall as they get older. Watch Dr David Shipway’s full description of how this works.
Causes of falls in older adults
Many health conditions and symptoms can increase the likelihood of falling, and a combination of two or more of these risk factors increases the risk even more.
Conditions and health factors that can cause falls include:
- Previous history of vertigo
- Health conditions that cause muscle rigidity and weakness, such as Parkinson’s Disease
- Difficulty seeing or hearing
- Cognitive impairment and dementia
- Conditions that cause rushed movement to bathrooms, such as incontinence
Studies have shown that on average, 50 to 60 percent of falls occur within the home3, and one of the main reasons for this is that, compared to a professional environment such as a care home, domestic homes are rarely designed to be easily accessible and navigable for the elderly.
Environmental factors that can contribute to falls include:
- Upturned carpet and loose rugs
- Poor lighting, especially on stairs
- Cluttered environments
- Slippery floors
- Lack of grab bars and railings
- Difficult access to bathrooms or bedrooms
- Changes in floor levels
In addition to the above health and environmental factors, there is a proven link between certain medications and an increased risk of falling among the elderly.
Some of the medications that are known to negatively affect balance and coordination include:
- Psychotropic drugs such as sedatives
- Antipsychotics and antidepressants
- Cardiovascular medication, such as beta-blockers or diuretics
- Anti-anxiety drugs, such as diazepam (Valium) and lorazepam (Ativan)
Please note that this isn’t a complete list of medications that can cause falls, and we would recommend you speak to your GP or doctor if you are worried about a certain medication you are taking.
How to prevent falls in older adults
Creating a safe environment
Because most falls happen at home, creating a safe home environment can be one of the most effective ways to prevent falls.
Areas to focus on include:
- Improving lighting in dimly lit parts of the home
- Fixing upturned carpet and securing rugs and mats
- Carpeting slippery floors
- Removing obvious tripping hazards
- Fitting grab rails, especially in bathrooms and along stairways
- Fitting non-skid mats in bathrooms
As you can see, there are lots of tactics you can employ to help prevent a slip or trip. You can also check out our list of five simple home modifications that can help prevent a fall.
Wearing the right footwear
In the “World Guidelines for Falls Prevention and Management for Older Adults”4, the American Geriatric Society and the British Geriatric Society have pointed out unsuitable footwear as a significant cause of loss of balance and bad gait.
Loose, worn, or backless slippers are not safe for the elderly, and shoes with poor grip or worn soles can cause you to slip easily, especially on wet or slippery surfaces.
Your shoes should be snug, grippy, and have a firm fastener.
Your risk of falling can be decreased through exercise. It has been demonstrated that exercises or training that improve gait, strength, and balance reduce the chance of falling and the likelihood of picking up injuries from falls.
If you trip and fall once, it’s common to become afraid to move around for fear of falling again. This actually decreases your mobility and raises the chance of subsequent falls. Instead, concentrate on preserving your mobility and strength so that you can navigate your home safely.
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