Falls and Older Adults : Preventing Falls and Fractures

by National Institute on Aging

(Page 3 of 7)

Falls and fractures are not an inevitable part of growing older. Many can be prevented. To reduce your risk of falls and fractures, you can

• make personal changes that involve your lifestyle or physical well-being
• make changes in your home
• consider using walking aids or other assistive devices
• take steps to maintain or improve your bone health.

Talk with your doctor or another health care professional about how to prevent falls at home and elsewhere.

Personal Changes

Many falls result from personal or lifestyle factors that can be changed. Your doctor or other health care provider can assess your risk of falling and suggest ways to prevent falls.

At your next check-up, talk with your health care provider about your risk of falling and changes you might make. You might be referred to another health care provider who can help. Also, let your doctor know if you've fallen or almost fallen.

Here are some changes you might make.

• Be physically active.
• Have your medicines reviewed.
• Have your blood pressure checked when lying and standing.
• Get a vision check-up.
• Choose safe footwear.

Be Physically Active

Regular physical activity is a first line of defense against falls and fractures. Physical activity strengthens muscles and increases flexibility and endurance. In turn, your balance and the way you walk may change, decreasing the chances of a fall.

It's important to keep muscles strong. Strengthening muscles in the lower body can improve balance. Work with your doctor or a physical therapist to plan a physical activity program that is right for you.

A supervised group program can help with balance and gait training. Strength and balance exercises done at home can also reduce your risk of falls. Whether done with a group or on your own, be sure your program becomes more challenging over time. This will help improve your balance and strength.

Tai Chi is one type of exercise that may help prevent falls by improving balance and control. This exercise uses slow, flowing movements to help people relax and coordinate the mind and body. It can also boost your self-confidence. Dancing and other rhythmic movements can help as well.

Mild weight-bearing exercise - such as walking or climbing stairs - may help slow bone loss from osteoporosis. Having strong bones can prevent fractures if you do fall.

Your doctor or a physical therapist can check your walking and balance. They might do a "Get-Up and Go" test. This simple test shows how steady you are when you get up from a chair. The test also is used to check your walking ability.

Have Your Medicines Reviewed

Find out about the possible side effects of medicines you take. Some medications might affect your coordination or balance, or cause dizziness, confusion, or sleepiness. Some medications don't work well together, adding to your risk of falls.

Bring your prescribed and over-the-counter medicines with you when you visit the doctor. Also bring any vitamins, minerals, and herbal products you are taking.

Ask if any of your medicines or over-the counter products could increase your risk of falling. Also ask if you no longer need to take any of your medications or if the doses might be decreased. Never stop taking your medications unless you talk with your doctor first.

Also, limit the amount of alcohol you drink. Even a small amount can affect your balance and reflexes.

Have Your Blood Pressure Checked When Lying and Standing

Some older people have normal or increased blood pressure while seated, but their blood pressure drops too much on standing. There is no way to know unless you check. Most often, though, your blood pressure is checked when you are sitting.

Your health care provider should check your blood pressure and pulse after you have been lying down for at least 5 minutes and again after you get up. If it drops too much when you get up, ask if any of your medications may be decreased or if you should make other changes. Drinking more water, getting up more slowly, pumping your feet or hands before getting up, or wearing special stockings can help, too.

Get a Vision Check-Up

Have your vision tested regularly or if you think it has changed. Even small changes in sight can make you less stable.

Wear your eyeglasses so you can see your surroundings clearly. Keep them clean and check to see that the frames are straight. When you get new glasses, be extra cautious while you are getting used to them. If you use reading glasses or multi-focal lenses, take them off when you're walking.

Choose Safe Footwear

The soles of our feet have nerves that help us judge the position of our bodies. To work correctly, our feet need to be in touch with the ground and our shoes need to stay securely with the foot as we take each step. Otherwise, falls may occur.

It's important to select your footwear carefully to help prevent falls. Wear sensible, low-heeled shoes that fit well and support your feet. There should be no marks on your feet when you take off your shoes and socks.

Your shoes should completely surround your feet. Wearing only socks or wearing floppy, backless slippers or shoes without backs can be unsafe. Also, choose shoes with non-slip soles. Smooth soles can cause you to slip on waxed or polished floors.

Quiz

1. One way to prevent falls is to

A. avoid physical activity as much as possible.
B. be physically active.

B is the correct answer. Regular physical activity strengthens muscles, enhances balance, and improves flexibility and endurance. This in turn helps prevent falls. Your doctor or a physical therapist can help plan a group or individual exercise program that's right for you.

2. It's important to have your medicines reviewed because

A. some medicines cause side effects that can lead to falls.
B. some medicines interact in harmful ways.
C. your doses might be too high.
D. all of the above

D is the correct answer. It's important to have your doctor review your prescribed medicines and over-the-counter products. Some prescribed medicines and other products cause side effects or interact in ways that can lead to falls. Also, some medicines may no longer be needed or the doses could be reduced. But, never stop taking your medications unless you talk with your doctor first.

3. Vision-related falls can be prevented by

A. having your vision tested regularly and wearing glasses if needed.
B. putting on reading glasses when walking.
C. wearing multi-focal lenses when walking.

A is the correct answer. Vision-related falls can be prevented. Have your vision tested regularly or if you think it has changed. Also, wear your eyeglasses if you need them, but take off reading glasses or multi-focal lenses when walking to avoid tripping.

4. Falls can be prevented by wearing

A. only socks or backless slippers or shoes.
B. loose shoes with smooth soles.
C. low-heeled shoes that fit well and support your feet.

C is the correct answer. Wear safe, low-heeled shoes that fit well, have non-slip soles, and support your feet. Shoes should completely surround your feet. Avoid backless shoes. Wearing only socks or floppy, backless slippers can be unsafe. Wearing shoes with smooth soles can be unsafe on waxed or polished floors.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.