Understanding Physical Changes & Ways to Lessen the Risk of Falling

One out of 3 adults over the age of 65 will fall this year, but fewer than half of them will talk to their doctors about it. Falls are the #1 cause of injuries in seniors that can result in hip fractures, cuts, and serious head or brain injuries.  Even if there is no serious injury a fall can still be frightening. Many folks are afraid they will fall again and 50% of them will.

No single recommended tool or intervention can reliably identify senior adults who are at an increased fall risk, but several reasonable and feasible approaches are available for clinicians to assist their patients that they care for. 

Falls are multifactorial which means there can be intrinsic and or extrinsic factors.  Intrinsic factors include one's medical condition, impaired vision, and hearing or other age related changes, such as lower extremity weakness, pain or joint range of motion limitations.  Extrinsic factors include medications, improper use or lack of appropriate assisted devices or one's living environment.  Environmental issues can include improper shoe wear, clutter on floor, carpets, or small dogs and cats.  The prevalence of falls increase with each decade of life. 

The American Geriatric Society suggest all seniors under the care of a health care professional should be asked at least once a year about falls, their frequency of falling, and or any difficulties they may be having with gait or balance. 

As a physical therapist, we use many forms of balance tests that can be performed to assess ones fall risk.  The Timed Up and Go test (TUG) is a quick screen that assess mobility, balance, and walking speed, which can help determine fall risk.  The gait speed is analyzed by assessing the time it takes to walk 3 meter or 9.8 feet.  Generally, 14 seconds is a cutoff speed that can determine fall risk.  In other works, if one can accomplish 3 meters in < 10 seconds they appear to be fairly independent.  10-19 seconds may be a modified independence while 20-29 seconds can indicate a moderate fall risk    Those who have a > 30 second speed may require some assist or may benefit with an assistive device.  The Berg Balance Test is another tool which is normally performed by the physical therapist.  This test is a combination of 14 mini tests that looks at one’s ability to sit to stand, stand with eyes closed, walk and turn, and stand on one foot.  Fall risk increases as one's score increases.

Finally, what can one do about lessening fall risk?    Be mindful of the factors in your home that were previously mentioned.   Exercise is imperative, keeping mobile, active and strong lessens the chance of further lower extremity weakness or disability.   Be mindful of changing position too rapidly which can cause a sense of off balance or even a blood pressure drop that can make one dizzy.

MMI physicians and therapists are very in-tune with safe mobility and prevention of falls.  We can help analyze your risk of fall and help to prevent and reduce the injury from falls.   Interventions such as a Dexascan can evaluate bone strength and specific balance and gait assessments followed by recommendations have been shown to reduce the incidence of falls.

If you have difficulty with rising from the chair, instability on first standing, decreased velocity with walking, call your physician or therapist for a detailed consult.

Understanding fall risk and being aware of any physical changes that you may be experiencing will help to lessen the chance that you will be a statistic for injury or compromised independence.