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Old Age and Falling: They Don't Always Go Together
By: HealthSouth Corporation

University of Michigan researchers say it's no longer safe to assume old age is to blame when Grandma falls in her kitchen

Instead, University of Michigan physicians have found they can work with older people to reduce their risks of falling by improving their coordination and balance. This is significant because falls and their damaging after-effects are the leading cause of accidental death in people over age 65.

A host of explanations may point to problems with mobility and balance, doctors say. And that should be good news to older people who have become so afraid of taking a bad fall that their sense of independence is threatened.

"We previously had not looked into falls because we thought perhaps this is just a part of age. It's not a part of aging. Falls are a manifestation of something wrong with the person," says Neil Alexander, M.D., director of the Mobility Research Center at the U-M Health System. "Balance disorders and falls are not often recognized as an important problem because a number of us younger people fall as well. The problem is when an older adult falls, they're more likely to have a major injury and, in fact, they tend to fall more often," he added.

Falls are serious stuff for older people. One-third of people age 65 and older fall every year, sometimes causing fractured or broken bones. One-half of those over age 80 fall. Falls also exact a financial toll, costing about $3 billion a year in medical treatment.

Alexander studies and treats balance disorders, which may have a variety of causes and typically become apparent with a fall. A person with a balance disorder has a high frequency of falls, perhaps twice in a six-month period."More importantly, these falls tend to be more injurious -- the people tend to hurt themselves more. And the person tends to be quite conscious of these falls and develops a fear of falling," Alexander says.

The first step is to examine a person's medical condition and possible physical problems: vision, inner ear, joints, strength and sensory functions. Next comes a plan for physical therapy, particularly a process known as balance training.

"Physical therapy is the cornerstone of fall management," says Alexander. Another key to keeping older people on their feet is to improve cognition -- working on their awareness of surroundings and any physical obstacles they may face in moving about. For example, people are taught to focus on a cracked or uneven sidewalk, giving it their full attention and not being distracted while walking.

"One way to get older adults to be more aware of the situation and be more attentive to their environment is to basically train older adults on irregular surfaces, and train them on the type of challenging surfaces they might see in their environment," Alexander says.

Other exercises involve improving stance, and well as learning to step rapidly, which can help prevent a fall. Alexander also stresses making changes at home to decrease the chances of falling. This may be removing loose rugs or adding no-skid pads; using nightlights; placing non-skid strips in the bathtub or shower stall; and improving outdoor lighting.

Facts about balance disorders:

• One in three adults over age 65 experiences a fall each year; by age 80, the proportion increases to one in two adults.
  
  
• Up to half of nursing home residents fall every year. * Balance-related falls account for up to $3 billion in medical costs annually.
  
  
• Balance disorders can be treated with cognitive and physical therapy, as well as safeguarding one's home.

  HealthSouth Corporation