Medicines make the elderly fall and injure themselves!

Recurrent falls are responsible for deaths among the elderly.

Editorial Team | Published: December 7, 2017 5:27 pm

When a person grows older, mobility concerns come into play. Falls are one of the major health problems amongst senior citizens and a common cause of injury in this age group; an event which is most of the times accidental and seen mainly in elderly individuals.Recurrent falls are a critical cause of morbidity and mortality in elderly and a marker of poor physical and cognitive status.Studies in Indian population have shown that incidence of falls in elderly (60yrs of age and above) ranges from 14% to 52%. An Indian study has found that after a fall, fracture is seen in 21% and other forms of injury in nearly 80%. Falls in elderly are one of the major contributors of hip fracture, spine injuries and severe head trauma. They are also major cause for hospitalisation of elderly and need for long-term institutional care.

Medications are one of the most common causes of falls in elderly. Taking five or more medicines (Polypharmacy) has been shown to be directly related to increased risk of falls. Medicines that act on the nervous system, particularly, sedatives, psychoactive drugs, anti-depressants, anti-histamines, medications affecting BP are some of the common reasons contributing to falls. Falls are generally a combination of several risk factors which can affect and threaten the ability of a person to continue with daily routine activitiesfor a living. Read more about Depression and home care:10 emotional needs of the elderly you MUST know about

Physical risk factors:

Ageing
Previous history of having fallen
Arthritis
Chronic medical conditions like Diabetes, Thyroid problems, Anemia
Neurological problems like Stroke, Parkinson disease
Vertigo and Balance disorders
Muscle weakness
Mood disorders like Depression and psychiatric issues
Impaired mental status like cognitive impairment and dementia
Visual problems like Cataract
Medications

Environmental risk factors:

Poor lighting
Slippery floors
Cluttered walkways
Wearing improper footwear
Incorrect use of the walking aids such as canes or walkers
Lack of grab bars in bathrooms
Uneven and broken sidewalks
Irregular steps
Unpredictable level changes

Falls can range fromtrivial to major injuries in the elders which are mentioned below:

Physical injuries like (muscle pains,scratches and wounds, hematomas,lacerations,fractures, head injuries leading to intracranial bleeding) and in severe cases can lead to death.
Self-imposed limitation of activity
Social isolation
Loss of independence
Poor quality of life

It is of utmost importance that the elderly report any fall that they may have had, when visiting their doctor for a check-up. Consultation with a Geriatrician (Elderly Care Specialist Physician) may benefit, as they are experts in preventing and managing falls. Gait and balance training, medication optimization, muscle strengthening exercises, home hazard modifications, correction of underlying problems like cataract are some of the preventive measures. An efficient preventive strategy is to educate patient and caregiver. The patient at risk and family members shown be educated about the multifactorial nature of falls, the specific risk factors and recommended interventions. Vitamin-D supplementation has been shown to be effective in preventing falls; but it should be taken only after reviewing with a doctor. Read here Good news! A new tool can trace Alzheimer’s risk in older adults

Depending on the severity of the fall and associated injury, the treatment options may vary. If there is a fracture, Orthopaedic intervention and corrective surgery is needed. Every individual with a fall needs to undergo detailed evaluation and assessment like review of medications, gait and balance assessment and other tests as per the need, medication optimization, gait and balance training, muscle strengthening exercises, using assistive devices like walkers, vitamin D supplementation, better home safety measures like hand rails, grab bars and raised toilet seats. Treatment of underlying cardiovascular or neurologic disorder and education of patient and caregivers regarding falls are important steps. Read more about More physical activity may reduce risk of death in older women

Caregiver assistance:

Frequent discussion with them about their current health conditions
Take them for regular eye check-up
Keep a watch on whether they are holding onto walls, furniture or taking help of someone when they are walking or face any difficulty in walking or getting up from a chair
Talk about medications
Eating healthy and food those provide nutrition
Wiping up the spills immediately
Keeping pathways in a good and clean condition
If they have difficulty in their daily activities or have balance problems or have fallen in the past, seek a consultation with a Geriatrician
Ensure that the elderly people are using assistive devices like canes or walkers, as prescribed by doctors

Image source: Shutterstock

Published: December 7, 2017 5:27 pm

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