Falls are a danger to seniors, but many are avoidable

This week’s Senior Health is written by Dr. Joseph Hanna, chairman of the neurology department and director of the Stroke Center at MetroHealth Medical Center.
by Joseph Hanna, MetroHealth Medical Center Friday July 11, 2008, 3:55 AM Updated April 9, 2009

Older adults are more apt to fall than young adults for a variety of reasons. We stay upright through a coordination of our senses and subsequent reaction to environmental changes. As we age, our sense of balance and sight diminish, which increases our risk of falling.

In addition, the speed of our reflexes slows, hindering our ability to stop a fall. Once we accept the increased chance of falling, it’s important to put a plan in place to try to avoid falls.

The statistics are sobering. Falls are the leading cause of death from injury among people 65 or over. About 9,500 deaths in older Americans are associated with falls each year.

The elderly account for 75 percent of deaths from falls. More than half of all fatal falls involve people 75 or over, although that age group makes up only 4 percent of the total population.

When we think of fall-related injuries, broken bones probably come to mind first. But in reality, traumatic brain injury is a common and critical consequence of falls among seniors. A recent report in the Journal of Safety Research said that in 2005, nearly 8,000 deaths and 56,000 hospitalizations were the result of fall-related traumatic brain injuries in people 65 or older.

When the head strikes a hard object abruptly, a number of safeguards in the body try to protect the brain. The skin and muscles in the scalp first cushion the skull. The skull may fracture or remain intact. Nevertheless, the brain continues to move in the same direction of the skull with the surrounding cerebrospinal fluid acting as a cushion.

Unfortunately, that protection doesn’t always prevent a brain injury. When the brain hits the skull, it can cause bruising on the brain. These bruises may disable the function of the region surrounding the bruise. The blood within the bruise may also lead to seizures either immediately or in the future.

Seniors can help prevent falls. Staying fit and limber may be the best safeguard. A daily exercise regimen structured around flexibility and balance has been shown to decrease fall-related injuries.

Several common activities that involve balance and flexibility include dancing and tai chi. However, any exercise regimen is better than none.

Modifying your environment also reduces the frequency of missteps. Inside the home, remove throw rugs and clear cords and clutter from walking paths. Make sure there is adequate lighting inside and outside your home at all times.

Install handrails on stairs and in the bathroom, as well as treads on stairs. The use of contrasting colors along the floor to warn of all height transitions gives an added visual cue to a potential hazard.

Walking is great exercise but take some extra precautions to avoid falls. Make sure you wear shoes with traction, especially on damp days.

Walking aids such as canes and walkers also provide important support.

Walk in the daytime when lighting is optimal and find a walking companion. In addition to providing welcome company, they can also help you anticipate treacherous paths and if need be, alert medical attention after a fall.

Despite all this bad news, the good news is that many injuries are avoidable. Simple precautions and daily conditioning help to minimize this leading cause of disability and death in older adults.

Trauma centers are ready and able to assist trauma survivors at all hours of the day and night every day of the year. Rehabilitation facilities can then assist trauma survivors after their acute care in returning to their communities.