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Many Factors Can Lead to Falls


Each year, 85 percent of all injury-related hospital admissions and more than 40 percent of nursing home admissions are related to falls, and the annual costs associated with falls and their complications are estimated to be in the billions of dollars worldwide. Balance issues that lead to falls can result from a variety of problems from genetics and illnesses to medication mismanagement and reactions.
 
Q. As an 80-year-old widower who lives alone, I notice that some of my friends are developing balance problems. I walk a lot. Do you think that will help me? What are other issues that impact balance in seniors and ways that adults can remain safe and independent at home?
  
Any number of factors from genetics to illness to medications including the mismanagement of prescription drugs may affect balance, which can lead to falls. According to research, people with severe white matter changes in their brains were twice as likely to score poorly on walking and balance tests, affecting how well they get around and keep their balance.
 
The three-year study, called LADIS (Leukoaraiosis and Disability), also found that people with severe changes in this white matter were twice as likely as the mild group to have a history of falls. The moderate group was one-and-a-half times as likely as the mild group to have a history of falls.
 
The study, coordinated by the Department of Neurological and Psychiatric Sciences at the University of Florence, involved 639 men and women between the ages of 65 and 84 who underwent brain scans and walking and balance tests. Of the group, 284 had mild age-related white matter changes, 197 moderate changes and 158 severe changes.
 
“Walking difficulties and falls are major symptoms of people with white matter changes and a significant cause of illness and death in the elderly,” said study author Hansjoerg Baezner, MD, PhD, with the University of Heidelberg in Mannheim, Germany. “Exercise may have the potential to reduce the risk of these problems since exercise is associated with improved walking and balance. We’ll be testing whether exercise has such a protective effect in our long-term study of this group.”
 
As you can see, you’re on the right track by exercising. Try to encourage your other friends to join you. Another way that you and your friends can safeguard yourselves is with a little extra help. Your local Home Instead Senior Care® hires CAREGiversSM to go into the homes of older adults to help with tasks such as meal preparation, light housekeeping, errands and shopping – or even a little companionship to brighten the days.
 
Inner ear disorders – often called vestibular disorders – are another cause of dizziness in older adults, which can lead to imbalance and place seniors at a higher risk for falls, according to research.
 
An estimated 35 percent of U.S. adults age 40 and older have vestibular dysfunction and it only gets worse with aging, according to the Archives of Internal Medicine, one of the JAMA/Archives journals.
 
Yuri Agrawal, M.D., and colleagues at The Johns Hopkins University School of Medicine, Baltimore, analyzed data from a nationally representative sample of 5,086 adults who participated in the 2001-2004 National Health and Nutrition Examination Surveys.
 
Participants completed a balance questionnaire, which determined history of dizziness and falls, and underwent in-person balance testing that involved standing on different surfaces under varying conditions (for instance, with their eyes closed).
 
As determined by these tests, the overall prevalence of vestibular dysfunction in the U.S. population aged 40 and older from 2001 through 2004 was 35.4 percent. Individuals with vestibular dysfunction were more likely to report having dizziness and a history of falls. The 26.8 percent of participants who had symptoms of vestibular dysfunction, including dizziness, had an eight-fold increase in the odds of falling.
 
Seniors should complete a physical examination and make sure they ask about ear and hearing issues or balance problems that they might be experiencing. If a senor is unsafe at home, having a caregiver/companion with him, even a few hours a day, could help put both at ease.
 
Finally, sedatives and the mismanagement of prescription medications are other likely culprits when it comes to balance problems that could lead to falls. According to an analysis of previous studies reported in a recent issue of the Archives of Internal Medicine, older adults who take several types of psychotropic medications such as antidepressants or sedatives appear more likely to experience falls.
 
In an analysis from John C. Woolcott, M.A., of the University of British Columbia and Centre for Health Evaluation and Outcomes Sciences, Vancouver, Canada, researchers evaluated 79,081 participants older than 60 years and nine drug classes. When the data were pooled and results adjusted for other factors, the use of sedatives and hypnotics, antidepressants and benzodiazepines were significantly associated with the risk of falling in older adults.
 
Medication interactions and reactions including improper use of prescription drugs also send many seniors to the hospital every year.
 
Home Instead CAREGivers can help seniors like you manage their medications, which will go a long way toward remaining safe and independent at home. A companion also can help encourage older adults to remain active, keep their spirits up and stay engaged in life.