The American Geriatrics Society and the British Geriatric Society recently updated their ten year old guidelines on preventing falls for older persons. The societies continue to acknowledge the role of falls in impaired function and early admission to long term care facilities as well as increased mortality of older adults.
Evaluation of Risk
The new guidelines recommend a complete, annual fall risk assessment for all older adults who visit their medical professional for a fall, or if balance or gait problems are noted. Issues to be considered include the frequency of falling, symptoms at the time of the fall and injuries from the fall itself.
Preventing Falls - The Major Recommendations
Physical activity - Most important for seniors aging in their homes is to participate in an exercise program that includes balance, gait and strength training, tai chi or physical therapy.
Home safety assessments and installation of appropriate home modification equipment by professionals are also highly recommended for all older persons who have fallen or who have other risk factors for falls.
Vision - Impaired vision is known to cause falls. Now, cataract surgery on the first eye is highly recommended where indicated as an appropriate intervention for fall prevention.
Medications have long been associated with fall risk, particularly since many prescriptions taken by seniors warn of dangerous side effects including dizziness. An annual medication review with the goal of reduction or withdrawal of prescriptions is now stressed for all older people, regardless of the number of medications they are taking.
Vitamin D is recommended as a daily supplement for all older adults at risk for falls, not only those with diagnosed deficiency. The new guidelines are for 800 IU daily, with special emphasis on those with gait or balance problems and those who reside in long term care.
Fall prevention programs involving patient and caregiver education are considered to be among the primary prevention measures.
Finally, new specific medical assessment recommendations include an evaluation of the feet and footwear, the use of mobility aids, home safety and examination of the individual’s functional ability and fear of falling.
Local Resources
Many East Bay service agencies and senior centers provide fall prevention information, home safety assessments and exercise programs. Contact the Fall Prevention Program of Contra Costa County at 925-937-8311, or visit their website. In Alameda County contact the Senior Injury Prevention Program at 510-577-3535, or visit their website.
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Information contained in this column is intended for health education purposes only and is not intended as personal medical advice. Readers should consult their personal medical professional in conjunction with the use of this information.
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