Reduce risk of falls to improve lifestyle

Every year, one in three adults over age 64 falls. Thousands of older adults die from fall injuries every year, and about 2 million are treated for nonfatal fall injuries in emergency departments.

“Half of falls occur in a person’s home. Falls are the main reason older people go to emergency departments,” said Steve Albert, co-director of the University of Pittsburgh Prevention Research Center.

But simple home modifications and exercises that improve strength and balance can help reduce the risk of falling.

The center is part of a nationwide network of 37 academic and community research partners funded by the Centers for Disease Control and Prevention to find ways to keep people healthy. Several prevention research centers conduct research on ways to help older adults avoid falling.

Albert is comparing the effectiveness of two fall-prevention programs, and health agencies will use the findings in choosing which program to offer.

“Most falls involve changing location, such as while walking or moving from a bed or chair,” he said. “Sometimes, falls happen when someone carries laundry down stairs without a railing.”

“Stairs are a challenge for people with balance problems,” said Dr. Elizabeth Phelan, a University of Washington Prevention Research Center researcher who runs a fall-prevention clinic in Seattle.

Because evidence shows that people can reduce their fall risk by improving balance and strength, Phelan refers many patients to EnhanceFitness, an exercise class developed by the Washington center. Proven to improve balance and strength, EnhanceFitness is offered at 450 sites nationwide.

Older adults who already have experienced a fall are at risk for more falls, Phelan said. She is researching the feasibility of emergency medical technicians’ providing fall-prevention information when responding to fall-related 911 calls. Acting on such information might reduce callers’ risk of future falls.

Phelan said the psychological consequences of falls should not be underestimated.

“People who fall may develop a fear of falling,” she said. “And because of that they may start limiting their activity, and that leads to what I call a vicious cycle or a downward spiral of worsening muscle weakness and an increased propensity for falls.

“A lot of older people don’t recognize that falls can, in a flash, change their independent lifestyle,” Phelan said. “Many older adults can no longer live on their own if they have suffered serious fall-related injuries.”

People should address fall hazards when they’re young so they can live at home as long as possible — a concept called “aging in place,” said Marcia Ory, a Texas A&M Health Science Center Prevention Research Center researcher.

Ory also works with the Healthy Aging Research Network, funded by the CDC’s Healthy Aging Program. The network is a group of prevention research centers that focuses on developing, testing and disseminating effective strategies for keeping older adults healthy and independent.

“The mantra for the HAN is ‘always plan for the future,’” Ory said.

Some older adults associate installation of safety equipment, such as grab rails in the bathroom, with “becoming frail and dependent,” Ory said. “But if the safety equipment had already been there, they might not think about it as a stigma.”

Ory studies how to implement effective fall-prevention programs and policies.

“Many states offer fall-prevention screening, referrals and programs, but more offerings are needed,” she said. “Older adults and their caregivers should ask their health care providers and public health agencies about these programs.”

A compendium of evidence-based programs to prevent older adult falls can be found at http://bit.ly/2d6UJG2.

For more information about the CDC’s prevention research centers program, visit www.cdc.gov/prc.

To Your Health is provided by the staff of Boulder City Hospital. For more information, call 702-293-4111, ext. 576, or visit bouldercity hospital.org.