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Falls!! Can They Be Prevented?

According to the American Physical Therapy Association (APTA) and other health professional organizations, falls are one of the most common ways older adults get injured here in the United States. Although common, falls are not part of normal aging and most falls can be prevented. The causes of falls can be found and addressed. Here are several facts and statistics associated with falls for the U.S.:

  • One in every four older adults fall each year
  • 30% of community dwelling older adults (65+) will have one or more falls a year
  • More women than men fall
  • 49% of falls occur in the home
  • There is a 60% chance of a fall reoccurring within 6 months for those who have had a serious fall
  • 30-70% of falls in older adults are due to trips, slips and missteps, mostly occurring during walking
  • Among older adults, falls cause over 39% of injury deaths, making them the leading cause of death by unintentional injury
  • Nearly three million older adults are treated in emergency departments for non-fatal injuries from falls, and more than 800,000 of these patients were hospitalized
  • Every hour, there are two deaths and 251 emergency department visits for fall-related injuries among older adults
  • Every 11 seconds an older adult visits the emergency room for a fall-related injury
  • In 2014, 27,044 people 65 years or older died from fall-related injuries in the U.S
  • Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture
  • Each year at least 300,000 older adults are hospitalized for hip fractures
  • More than 95% of hip fractures are caused by falling, usually by falling sideways
  • Falls are the most common cause of traumatic brain injuries (TBI)

The Good News

Most falls result in minor or no injuries with only 10-24% resulting in an injury. The US Public Health Service also reports that 2/3 of falls are potentially preventable. So then, what are the risk factors or what disposes us to have a greater chance of a fall? And what can you do to decrease your risk of falls?

What Are The Risk Factors?

There are several risk factors associated with a higher risk of falls. While one or two of these risk factors will not necessarily increase your risk of falling by much, a combination of these will. These risk factors are:

  • Muscle weakness
    • This is often caused by being sedentary or being inactive for an extended period of time
  • Foot problems
    • This includes footwear and musculoskeletal changes to your foot and ankle
  • Cardiac/heart rate rhythm problems
    • Irregular heart rate and blood pressure can lead to conditions that affect how you maintain an upright posture
  • History of Falls
    • Previously falling increases your risk of falling again in the future
  • Vision Problems
    • Vision is very important and vision is, in fact, one of the three systems that work in maintaining proper balance
    • Vision loss can lead to balance impairments and increase your fall risk
    • Common eye conditions as we age include cataracts and macular degeneration which affect how well we see
  • Dizziness
    • There are many reasons why you can become dizzy and it is important to have this examined by a healthcare professional as dizziness can result in a fall
  • Multiple Medications
    • Several medications have side effects which can include dizziness, blurred vision and other symptoms that can affect your balance
    • The more medications you are on, the more likely that they will increase your risk of falls
  • Difficulty With Walking and Balance
    • Difficulty walking or having a compromised balance will increase your risk of falling
    • The cause for this could be related to many reasons, including the previously mentioned risk factors

In addition to the above risk factors, there are several medical conditions that can also increase your risk of falls. These conditions are:

  • Diabetes
    • Uncontrolled diabetes can lead to peripheral neuropathy, visual and sensation changes, which can increase fall risk
  • Arthritis
    • This affects the cartilage tissue in your joints, which can become severe enough to affect balance and your gait pattern
  • Osteoporosis
    • This can lead to changes in your posture and increase your chance of fracturing a bone if you do fall
  • Stroke
    • This can have permanent mental and physical changes, which can affect balance, gait and muscle control
  • Cardiovascular Conditions
    • This can lead to dizziness when standing known as orthostatic hypotension
  • Neurological Diseases
    • Conditions such as Parkinson’s Disease, Alzheimer’s and dementia can affect your balance and the way you walk
    • This can affect your balance and fall risk
  • Mental Health Disorders
    • Examples include anxiety and depression
    • These mental health disorders can affect your ability to move and walk normally, which can affect your risk of falls

How Do You Prevent Falls?

To prevent and decrease your risk of falls, be proactive by going in to get your balance, and falls risk assessed. This is done through a multifactorial approach where you potentially need to go see multiple healthcare providers, which include your primary care provider and physical therapist. The National Council of Aging has six recommendations on how to prevent falls:

1. Find a good balance and exercise program

  • This is where a physical therapist can help
  • Your physical therapist can provide and recommend appropriate community programs

2. Talk to your health care provider

  • This starts with your primary care provider and they may recommend physical therapy
  • A physical therapist will perform a thorough balance and movement screen and strength and falls assessment, where they will determine your risk of falls
  • They may recommend starting physical therapy to improve your balance and learn safety protocols on how you can decrease your risk of falling
  • You will receive an individualized, comprehensive home and clinic exercise program, that will target all your impairments related to your balance and reasons why you are at risk of falling

3. Regularly review your medications with your doctor or pharmacist

  • They know what prescribed and over-the-counter medications can increase your risk of falling

4. Get your vision and hearing checked annually

  • Update your eyeglasses as recommended by your optometrist/ophthalmologist
  • Your vision and hearing are key to keeping you on your feet

5. Keep your home safe

  • Remove any items from your floor that you can trip over
  • Arrange or remove furniture so there is plenty of room for walking
  • Make sure your home is well lit, particularly at night when getting out of bed to use the bathroom
  • Use bath mats in the shower
  • Install grab bars in the bathroom

6. Talk to your family members

  • Ask for their support in taking these recommendations to stay safe

If you have any concerns or have a history of falls, please go in to talk to your primary care provider and go see your favorite MTI physical therapist get a thorough assessment. Remember most falls are preventable and do not have to be part of normal aging!



David Hernandez, is a Doctor of Physical Therapy who practices at MTI Physical Therapy’s Magnolia Clinic. David has been a physical therapist for three years and has treated everyone on the life spectrum from adolescents to older adults. David regularly sees individuals with balance and gait issues. He is committed to thoroughly treating these individuals to ensure they remain safe, independent as possible and to minimize their risk of falling.

He is originally from Reno, NV, but fell in love with Washington when he first visited in college, which he now happily calls home. His pastimes and hobbies include the outdoors and traveling, which he often combines as he sets off all over the world.

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