Why Fall Prevention Is Invaluable After 65

As you age, the risk of falling increases, and with it the risk of broken bones, damaged tissue, and possibly traumatic brain injury. These lead to extended hospitalization and rehabilitation stints, with each fall taking a worse toll on your body and your mental health. In 2020, the CDC reports, falls among adults 65 and older caused over 36,000 deaths. That made it the largest cause of death from an injury in that age group.

At AGP Family Health Clinic in Tomball, Texas, board-certified family physician Dr. Robert Pedroza understands the needs of patients, from infants to the elderly. He and our team provide  geriatric care for those with their unique needs, including an increased risk for falling and serious complications from those falls. Falling, though, doesn’t have to be inevitable as you age; taking proactive steps to prevent falls can help.

What causes falling in older people?

Falling is a complicated affair, with a number of different factors that combine to increase risk. First, older people tend to have more medical problems than those who are younger, including age-related deterioration of muscles and bones. That can lead to difficulty walking, loss of sensation in the legs and feet, and unstable joints.

In addition, post-menopausal women can develop osteoporosis, a bone-thinning disease that increases your risk for fractures (even spontaneous ones), especially in the hip and the spine.

Second, visual problems, including glaucoma and age-related macular degeneration (AMD), as well as declining cognitive function, can compound the problem because a person may not be aware, or not understand, that they’re at risk for a fall.

Third, as you get older, you also tend to be on more medications for chronic problems, and the competing side effects can impair walking ability and sensory perception.

The geriatric fall risk assessment

To decrease geriatric falls and their associated risk of major health complications, the CDC and the American Geriatric Society recommend a yearly screening for fall risk for everyone 65 years and older. If the screening shows the patient is at high risk, the doctor should perform a formal assessment, a series of tasks specifically designed to identify and mitigate fall risk.

In line with that recommendation, the CDC developed a program called STEADI (Stopping Elderly Accidents, Deaths, and Injuries) that contains three parts: screening, assessing, and intervention (recommendations to reduce your fall risk).

During the screening, the doctor may ask if you:

• Have fallen in the past year
• Feel unsteady when walking or standing
• Worry about falling

If you require an assessment, Dr. Pedroza tests your strength, balance, and gait using the following assessment tools:

Timed up-and-go (Tug)

This assessment tests gait. You sit in a chair, stand up, then walk for about 10 feet at a normal pace. Then you’ll turn and return to the chair and sit down. Dr. Pedroza notes how long it takes you to perform the sequence. If it’s 12 seconds or more, you could be at high risk for a fall.

30-second chair stand test

This test checks your strength and balance. You sit in a chair with your arms crossed over your chest. You stand up and sit down repeatedly for 30 seconds, while Dr. Pedroza counts the number of times you comfortably do this. A lower number means less strength and indicates higher fall risk.

4-stage balance test

For this test, you stand in four different positions, staying in each for 10 seconds. They become harder as you go.

1. Position 1: Stand with your feet side-by-side
2. Position 2: Move one foot forward until the instep touches the big toe of your other foot
3. Position 3: Move one foot completely in front of the other so the toes touch the heel of your other foot
4. Position 4: Stand on one foot

If you’re unable to hold either position 2 or position 3 for at least 10 seconds, and/or if you can’t stand on one foot for five seconds, you don’t have good balance. That means you’re at a higher risk for falls.

Dr. Pedroza discusses the assessment results with you and any caregiver you wish to include. He offers recommendations for physical and lifestyle adjustments you should make to decrease your fall risk. Some suggestions might be to use a cane or a walker for balance, install grab bars in the bathroom and shower, or remove carpeting from stairs if you have them. Many people fall when they trip on the edge of a rug.

Need help for yourself or a loved one with fall prevention strategies? AGP Family Health Clinic can help. To get started, give our office a call today at 832-861-0393, or book an appointment online.