Falls are a major health problem for many older Australians. Approximately 30% of adults more than 65 years of age will experience at least one fall per year. While many falls go undocumented because there is no apparent trauma, others result in a fractured hip, shoulder, or wrist, even an extended stay in hospital and rehabilitation. And in the worst cases can be life-threatening.
Along with the significant effect on your quality of life, the healthcare costs associated with recovery from falls will escalate as the number of older people significantly grows.
While falls may be common, they are not a normal part of ageing and the risk of falls can be minimized. As we grow older, we lose our strength and power of our limb muscles – about 10% a decade from 40 onwards. And addressing this provides a protective factor against falls.
So why are older people at risk of a fall?
There are many reasons people fall including muscle weakness, dizziness, poor sensation in the legs and feet, and poor eyesight just to name a few. And disturbingly once you have fallen once you are significantly more likely to experience subsequent falls.
Your muscles provide you with the limb strength and power to stand and move, as well as providing the control and strength required to remain balanced. Weak muscles reduce your ability to stay upright and react to walking on uneven surfaces or being bumped by other people or obstacles. If you have weak back and buttock muscles, it makes you more likely to fall forwards, and conversely if you have weak abdominal muscles you are more likely to fall backwards. Weak muscles at front of your lower leg (dorsiflexors muscles) that help you lift your toes as you walk predispose you to catching your toe and then falling.
As we grow older, we lose our strength and power of our limb muscles – about 10% a decade from 40 onwards. So, we need to work at keeping our muscles as strong and powerful as possible to reduce the likelihood of falling. This can be done with appropriate exercises (see below).
Reduced balance can occur because of:
- Sensory impairment in the feet and lower legs. This presents as numbness with decreased sensation in the legs, especially the feet. If your feet are numb, your body is unable to determine where your legs are placing your feet as you walk. To compensate you need to look down at your feet. Impaired sensory feedback therefore can predispose you to falling because you are not able to adjust to small changes in the ground surface and you are looking at your feet rather than your surroundings.
- Joint degeneration. Each of your weight-bearing joints have receptors that tell your brain where your joint is in space relative to the other body parts and the ground. This is called proprioception. It helps us to react to external disturbances to our balance helping us to stay upright when we are walking or moving about. If our joints have some degeneration, those receptors can be damaged and less sensitive, so we are not able to react as well. In these situations, we become more reliant on our eyesight and muscles to stay balanced.
- Visual impairment. We use our eyesight including our peripheral vision, to assess our environment to navigate around obstacles and hazards. Poor vision makes it far more likely to fall over those unseen obstacles.
- Dizziness will predispose you to falling. Reasons for dizziness are numerous but may include issues with blood pressure, the inner ear, or neurological problems.
- Medications can have side effects that cause some of the impairments noted above such as dizziness, muscle weakness, visual impairments and other sensory changes. This is can be worse if you are taking more than one medication.
8 tips to reduce the risk of falling
- Exercise for improved strength and power: As people grow older, they lose their strength and muscle power. Regular exercises to improve the strength and activation of core, buttocks and lower limb muscles reduce the likelihood of falling. Many of the exercise challenges we have highlighted in earlier blogs provide those exercises. See Challenge 1, Challenge 2, Challenge 5 and Challenge 7.
- Exercises for improved balance: Specific balance exercises as featured on one of our recent blogs will help the proprioception of joints to sense foot placement during walking and moving, reducing the risk of falling.
- Dizziness: if you are experiencing dizziness, visit your doctor. Your doctor may also review your medication to ensure it is not the causative factor.
- Footwear: ensure you have supportive, well-fitting, and non-slip footwear as you walk around the house and outside.
- Eyesight: Vision can deteriorate slowly and insidiously! Poor eyesight (e.g. peripheral vision) can contribute to the risk of falling. Get your eyesight checked regularly to monitor your vision.
- Adequate lighting: ensure you have adequate lighting in the household and particularly in the evening to avoid tripping.
- Walking assistance: the fear of falling is highly correlated to falling. If you are feeling vulnerable to falling, have rails installed in your home for assistance where needed or use a walking aid to improve your balance. Often a walking stick when you feel unsafe outside the house can make a large difference providing more stability and reduce your risk of falling.
- Home hazards: examine your home and declutter to determine whether you can reduce the chance of tripping or falling. Trip hazards can include unnecessary rugs, furniture, electric cords, or cluttered areas that you need to navigate.
Outside the house, the garden hose is particularly problematic so make sure it is rolled up out of the way.
Want to know more? Follow this link for some of the important factors associated with falls and strategies you can adopt to reduce the chance of you or someone you know who is vulnerable to falling.
I hope you find these tips useful.