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House calls are meant for patients who are temporarily or permanently home bound, or for other good reasons can't make it into the office.

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Thursday, March 18, 2010

For Seniors, falling could be dangerous

Almost 30% of people over 65 fall each year. Ninety percent of all hip fractures are associated with falls. Approximately 300,000 hip fractures and more than 700,000 vertebral fractures occur each year, mostly in the elderly. The yearly direct cost for fall-related fractures was estimated at 20.2 billion dollars in 1994, and is estimated to reach over 32 billion dollars im 2020. Unintentional fall is the seventh leading cause of death among people over 65 years old. Falls are a primary reason why Seniors become home bound.

Work done at our own office (when Health Extenders was active), funded by us and the South Western Connecticut Agency on Aging 5 years ago, arrived at interesting results.

Our study showed that Seniors of non-minority groups experienced more falls than minority Seniors. Thirty two percent of the non-minority Seniors fell in the year before the study. Hispanics had fewer falls, 26%, and Afro-Americans had the lowest rate, 10%. Risk factors for falling included: muscle weakness; instability due to poor balance; agility and endurance; the use of certain medications, especially sedatives and muscle relaxants, and impairment of gait, vision and hearing.

The danger of falling increased with each risk factor, and with the number of previous falls.

The risk of sustaining a fracture after a fall is associated with two important factors: low bone mineral density (osteoporosis), and neuromuscular integrity. Generally, the higher the bone density, the higher the ability of bone to withstand the abnormal forces of a fall, and the lower the risk of a fracture. Neuromuscular integrity is associated with muscular strength, balance and agility, and with an ability to absorb the high force of a fall.

Appreciable increases in bone density occur when new muscle groups become active over time and the forces generated by these muscles increase with time. Vigorous walking, by itself, does not generally bring about a sufficient increase in bone density to decrease the risk of fractures from falling. Despite the general health benefits of regular exercise, the main benefit of a fall prevention program is derived from increasing muscle strength and coordination, and from decreasing the instability of gait.

Despite the gloomy-looking statistics, the good news is that most risks for falling and sustaining a serious fracture can be controlled. When guided by an experienced exercise physiologist and/or physical therapist, muscle strength and agility can be increased, and balance and coordination can be dramatically improved. Medications may be adjusted to reduce dizziness; other medications, designed to decrease bone loss, can be used to decrease the chance of a fracture in the event of a fall. When necessary, specially tailored hip padding can be worn to absorb the shock of falling and prevent a fracture. In addition, home safety is extremely important. Helpful tools include rails in bathrooms, special chairs to sit on while showering, and the use of a walker. Avoidance of loose carpet edges and unstable pieces of furniture is a must.

The tendency to fall increases with age, but fall prevention is effective at any age, and should be a part of good health habits of every Senior Citizen.

For additional information on fall prevention, you may contact our office.

Twitter / Dr. Staw