Carol Cummings, RN, BSN, Expert on Aging Well

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15 August 2016


One of the greatest health concerns for older adults is that of falls. Each year in the United States, one in three people over the age of 65 has a fall. In the age group over 80, the number increases to one in two. For an older adult, the consequences of falling can range from minor injury to devastating trauma, even leading to death in some cases.  Those who fracture a hip or have other major trauma requiring surgery are at great risk for complications that lead to the need for a higher level of care. Only half of older adults hospitalized for a broken hip can return home or live on their own after the injury. In addition to physical injury, the psychological consequences of falling include fear and depression, both of which increase the risk of having another fall.

Obviously, the best way to minimize the impact of falls is to prevent them altogether. This requires awareness of the problems associated with falling and a proactive plan. The causes of falls and their prevention are a matter of intense public health concern. The problem is complex and requires individual attention and planning.

Causes of Falls

The reasons for falls are many and vary from one person to the next and from one fall to the next. In many cases, a combination of factors is involved.

Falls can be caused by intrinsic factors- those occurring inside the body, or extrinsic factors-those occurring from an outside cause. In reality, most falls have both intrinsic and extrinsic factors. In today’s blog we will look at some of the intrinsic factors.

As we age, a number of changes can occur which contribute to an increased likelihood of falling. Most notably the sense of balance can change and reaction time slows down a bit, therefore regaining footing after tripping becomes more difficult. Specific factors that contribute to falls include:

  • Health conditions including: Arthritis; Neuropathy (often present in diabetes); Low vision caused by macular degeneration or glaucoma; Dizziness and neurological conditions such as Parkinson’s disease; Changes in blood pressure that occur with position changes-called postural hypotension- can be caused by some medications or by certain conditions. Changing positions too quickly can lead to lightheadedness and falling. 
  • Time of day-Many falls occur at night when arising from sleep may render a person confused, drowsy and/or in a hurry to get to the bathroom. 
  • Medications-Medications can contribute to fall risk because of side effects or drug interactions. People who take more than four medications are more likely to fall. 
  • Muscle weakness-Older people with muscle weakness are more likely to fall than those who maintain their muscle strength, flexibility and endurance. 

If you or a loved one experiences a fall it is important to work with your health care provider to evaluate all of the reasons for the fall. Then make a plan to minimize the risk factors. Recovery from a fall is not only physical, but psychological. After a fall many people develop a fear of falling-which ironically is a risk factor for falls. One of the ways to overcome this is to make changes in the factors that have led to the fall. 

In next week’s blog we will look at extrinsic factors for falls and provide some home safety tips.

Be Well on Purpose! 


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