What is the most common trauma seen in the emergency department? Not motor vehicle accidents. Not sports injuries. It is falls!
At any age, our two-legged stance makes it easier to fall over than our four-legged friends. As we get older, falls become more common for many different reasons. We have all fallen. How do we know if there is a problem? If you have had two or more falls in a year there may be a problem that can be addressed to lower your risk. If you have had a fracture, you likely need to build up your strength and balance.
As people age, their muscles lose bulk and take longer to rebuild after being inactive. Balance also becomes worse due to vision changes, hearing changes, loss of sensation and arthritis effects.
It turns out that doing different kinds of physical activity work best to improve balance. Walking is one type of exercise that helps and is usually the easiest to start and continue at any time of life. Specific balance exercises like T’ai Chi have also been shown to reduce the risk of falls. Strengthening exercises also play a role and can include the normal lifting and carrying we do in our life — like gardening or bringing in the firewood.
If you have gotten weak, physical therapy can make a big difference and get you on the path to continuing exercise on your own.
The side effects of many medications can increase the chance of falling. Two major groups of medicine increase the risk — those that can cause sleepiness and those that cause dry mouth/dry eyes. Sedatives affect judgment, slow reflexes and therefore increase the chance of falling. Medicines for sleep or anxiety or muscle relaxants fall into the sedative category. Anticholinergic medicine cause dry mouth, can affect vision and cause confusion. Medicines in this category include antihistamines like Benadryl, medicine for incontinence and others.
How do you know if you are on a medicine that can increase the risk of falls? You can ask your pharmacist or physician or check the ‘Beers List’ online. Sometimes the medicine is worth the risk of it affecting balance, but it helps to know you need to be more careful.
Sometimes the layout of our house puts us at risk of falls. Keeping frequently used foods and dishes in easy to reach places can help so that you do not need to climb up to reach what you need. Look for rugs with edges that curl up or so much furniture, it is hard to navigate from one room to the other. Put no-slip surfaces on stair treads to lower the chance of slipping during the wet or icy seasons. Use sand on walkways to make them less slippery during the winter. Make sure there are sturdy handrails to hang on to on stairs or the bathroom.
We know that moving our bodies helps mood too. One thing the pandemic made clear is that being cooped up by ourselves is not good for our mental health. So keep active at any age.
Dr. Tanja VanderLinde works with Concord Hospital Internal Medicine.