Causes of Falls in Older Adults

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Among people over 65 years of age, falls are the primary cause of serious injuries and accidental death — everything from broken bones to traumatic brain injury. Statistically, if you've fallen once, your chances of falling again rise by a factor of two.

And even when falls do not cause injury, they tend to create a self-defeating downward spiral. People who have fallen fear falling again and tend to reduce their daily activities. Decreased activity causes further deterioration in lower-body strength, agility and reflexes. Loss of conditioning then increases the risk of falling again.

It's a vicious cycle.

Causes of falls in older adults are numerous and, in many cases, complex. The United States Centers for Disease Control and Prevention attributes most falls to a combination of risk factors. Risk factors may be personal or related to the environment; the more risk factors an older person is experiencing at any given time, the greater the chances of falling.

Understanding what causes falls in older adults is the first step toward reducing falls and injuries. Some fall causes are preventable; others may be reduced or mitigated with the assistance of health care professionals and by reducing environmental risk factors.

As we age, our vision, hearing, sense of balance and even tactile sense (touch) lose acuity and refinement. And we need keen senses to keep us on our feet. Unseen trip hazards can cause falls; so can unheard moving obstacles (like pets). Inner ear problems become more common as we age, affecting the ability to maintain balance and stability and to regain it quickly once we stumble or wobble.

Older adults who have not had a full vision, hearing and balance assessment should speak with their physician about the most common causes of falls and whether they may be able to improve their risk profile. Improving the home may also help to prevent sensory-related falls. Installing more light in more places, reducing background noise and removing extraneous clutter and obstacles can help older eyes, ears and feet navigate home safely.

Many of the diseases and conditions we typically associate with aging can cause symptoms that directly or indirectly contribute to falls. From the gradual onset of physical limitations to changes in mental status, many of these risk factors are directly tied to the propensity to fall.

People who are under a physician's care for diabetes, heart disease, neurological conditions and many other chronic diseases are at a higher risk for falls. At the time of any new diagnosis, discuss fall risks and a collaborative treatment plan that include strategies to safely maintain as much strength and independent activity as possible through an appropriate exercise program. Many older adults take Tai Chi classes specifically because it emphasizes lower body strength, stability and balance — all critical for reducing the risk of falls.

Causes of falls in older adults may also include dizziness, lightheadedness and fainting. These may be triggered by many different underlying conditions: inner ear issues, dehydration, vertigo even postural hypotension (a drop in blood pressure that occurs when standing from a sitting or lying position). A doctor can undertake a medication review to identify potential medication-related sources of dizziness and lightheadedness. He or she may recommend pressure stockings in some cases, or even medications to slightly raise blood pressure if faintness is an ongoing concern.

As we age, the wear and tear of time begins to accumulate in our bodies. If we haven't been intentional about maintaining our lower-body strength, flexibility and balance, we can begin to lose these. Painful limitations that affect the gait (stride length, velocity and balance) can arise from many physical sources: degeneration, inflammation, swelling, and instability in joints, bones, muscles, ligaments, tendons or nerves are common sources. Arthritis and foot problems (callouses, bunions, overgrown or thick toenails or other podiatric issues) are others. Every disorder that can cause pain in the hips, knees, feet, ankles, back, neck, arms, and feet can reduce mobility, limit activity and contribute to falls.

For people who struggle with physical sources of discomfort when walking, a physician partner is critical to help manage risk factors. In many of these cases, surgery or pain management strategies may be required to help mitigate the most common causes of falls in older adults through conditioning and regular lower-body, weight-bearing exercise.

While living in the era of advanced pharmacological science is a blessing in many ways, it is ironic that prescription drugs themselves — especially when more than three are taken regularly — are sometimes what causes falls in older adults. The National Council on Aging has identified the classes of pharmaceuticals most likely to increase fall risks:

• Psychoactive medications
• Antihistamines
• Muscle relaxants
• Blood pressure medications
• Anticholinergics

The most common causes of falls are frequently things we rarely take the time to think about because they are simply a part of "home." But home is where most falls occur, and managing the causes of falls in older adults begins with creating a safe environment.

Environmental factors that should be considered to reduce fall risks include:

• Dim lights
• Cords on the floor or in walking pathways
• Ill-fitting shoes
• Shrub branches extending into the walkway outdoors
• Uneven pavement
• Low chairs that are difficult to sit in or rise from
• Slippery bathtubs
• A lack of grab bars and handrails throughout the home

A comprehensive fall safety plan starts with removing unnecessary risks and also includes proactive measures for those at risk, including a medical alert device with fall detection capabilities and a commitment to wearing it at all times. The Centers for Disease Control provides a comprehensive home fall safety checklist that can serve as a guideline for families, caregivers and older adults who want to take control of their surroundings to make them as safe as possible for many more years of active and healthy independent living.

By Lively from Best Buy Health

Lively from Best Buy Health aims to enrich and save lives through technology and meaningful connections. Together we are focused on enabling care at home by providing consumer health products that help customers live healthier lives, device-based emergency response services for the active aging population and virtual care offerings that help connect patients and physicians. Today, over a million people are using Best Buy Health technology to stay connected, safe and healthy. For additional information, we encourage you to visit us at lively.com and connect with us on Facebook and Instagram @LivelySocial