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Preventing falls

Cause and risk factors in older adults
older adult lifting weights
© CQUniversity 2021

Fall Prevention: Cause and Risk Factors In Older Adults

  • Falls occur due to an underlying cause or risk factor
  • Falls are linked to the physical condition and/or a medical problem
  • Normal ageing brings physical, cognitive and affective changes that may contribute to falls
  • Such change seclude sensory, metabolic, neurological and musculoskeletal changes
  • Falls are more prevalent in females than males
  • Frailty, immobility and acute and chronic health conditions are markers for falls
  • Falls diminish function by causing injury, limiting activity, losing mobility and increasing the fear of falling
  • Serious injuries include fractures of hip, wrist, humerus, and pelvis and often are a combination of a fall and osteoporosis
  • Falls can also be caused by loss of consciousness, stroke, heart attack, vertigo or an external blow
  • Environmental factors must not be disregarded – trip hazards, inappropriate stairway design, wet slippery surfaces, clutter, poor lighting etc..

Risk Factors

  • Muscle weakness – in particular legs- not just strength but also endurance and flexibility
  • Balance and/or gait – lack of activity, neurological cause, arthritis or other bone or tissue disease
  • Changes in blood pressure – postural hypotension when changing body positions, dehydration, types of medication, neurological disorders like Parkinson’s, an infection and even diabetes
  • Postural hypotension is often accompanied by dizziness
  • Slow reflex times – with slow reaction time if they trip they are likely to fall
  • Painful feet and wrong footwear – slippers, high heels, and smooth soled shoes can all contribute to a fall
  • Sensory problems – numbness in peripheries like feet. Secure contact with foot placement is compromised
  • Vision problems – issues with depth perception and poor awareness of surrounds. Glaucoma, cataracts, macular degeneration and multifocal glasses all contribute to poor environmental perception
  • Mental confusion
  • Medications – multiple medications are more likely to cause issues.

Reading Please read the following article

Falls Risk Screening

Stay On Your Feet Program

For Health Professionals

  • A falls risk assessment is available – FROP
  • Physiological profile assessment – PPA
  • Examples of screening tools
  • 6-metre walk – gait speed
  • Alternative step test – time and coordination
  • Elderly Fall Screening test (EFST) – 5 items – low/high risk, based on falls history, walking speed and gait style.

Examples of Screening Tools

Berg Balance Scale

  • Developed to measure balance among older people with an impairment in balance function by assessing their performance in functional tasks
  • Used in clinical practice and research
  • 14 item scale which provides a risk stratification to assist with intervention strategies.

Heath Issues Needing GP Investigation

  • Vasovagal syncope – fainting
  • Orthostatic hypotension – drop in blood pressure when standing from sitting or lying positions
  • Carotid sinus hypersensitivity – mechanical forces like head-turning or looking up result in greater than expected changes in heart rate and blood pressure drop.
  • Cardiac arrhythmias – age can cause deterioration of the heart’s electrical conduction system
  • Dizziness/ vertigo – vestibular disorders (ears).
© CQUniversity 2021
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