From the Experts

Taking Steps to Prevent Falls

Kristen D. Smith, MPH

By Kristen D. Smith, MPH
Co-Chair of the Fall Prevention Task Force and Health Promotion Manager for Aging & Independence Services, County of San Diego

Have you or a loved one slipped and fallen recently? If so, you may be one of thousands- almost one in three older adults – who fall each year. What was the cause of your fall? Was it tripping over a crack in the sidewalk? Did it happen when you were trying to get in or out of the bathtub? Did you suddenly lose your balance when you were standing up?  When older adults fall, it can lead to a decline in their health.

We probably all know folks who were doing just fine in life, until they took a fall, broke their hip, and were never able to be as independent as they once were.

The consequences of falls include not only the costs incurred by treating injuries, but also the decline in quality of life caused by loss of independence that many people suffer after a serious fall. Not all falls result in injury, but once people fall, they at higher risk for falling again.

What are the causes of falls?

Falls are not simply accidents. There are many reasons why people fall. Older adults can do something about these risk factors, and greatly reduce their chance of falling.

Older adults are at higher risk of falling than younger adults because of several changes that often occur as a result of aging. These changes, in combination with lifestyle and environmental factors, put older adults at higher risk of falling.

For example, the same house that worked very well for a person at age 40 may not be as safe for the same person at age 70. Some lifestyle factors, such as wearing high heels or drinking alcohol, may not have adverse effects on balance in youth, but when combined with the effects of aging, may increase the risk of falling.

Age-related changes that contribute to fall risk include changes in balance and how we walk, sensory changes (such as decreased vision, affected hearing), and changes in reflexes. Older adults often have more chronic illnesses, requiring multiple medications, which increase fall risk. Also, osteoporosis increases the chance of injury if a fall occurs.

Lifestyle factors include lack of physical activity and using inappropriate aids for walking (such as an improperly sized cane). Also, fear of falling is a risk factor. Some people become so afraid of falling that their fear hinders them from going out as often as they would otherwise, and then they become more sedentary, which puts them at higher risk.

Staying physically active is one of the best things you can do to prevent falls. Physical activity, in the form of exercise, such as gardening, walking or golfing, keeps us limber and strong, both necessary ingredients to maintain balance. Tai Chi is one exercise that has been proven to reduce the risk of falls.

Environmental factors include those aspects of our homes and public places that contribute to falls. Stairways and bathrooms are some of the more dangerous places – and installing handrails and grab bars can help reduce the fall risk. Proper lighting is important. Throw rugs and electrical cords on the floor also present obstacles. Raised cracks in sidewalks and unmarked curbs can contribute to falls in public places.

Many falls are preventable

So, the bad news is that falls are very common; they happen for lots of different reasons; and the consequences can be long lasting. But the good news is – falls are actually preventable! You can do something to reduce your own risk. The San Diego Fall Prevention Task Force has several initiatives to reduce falls in our community.