Tag Archives: falls

Reducing trip hazards and decluttering can prevent falls among older people living at home

Eliminating hazards around the home, such as clutter, stairs without railings and poor lighting, can reduce the risk of falls for older people by around a quarter, according to a new Cochrane review.

The review did not find any compelling evidence for other measures to reduce falls, such as making sure older people have the correct prescription glasses, special footwear, or education on avoiding falls.

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It also found that decluttering and reducing hazards had the most benefit for older people who are at risk of falls, for example because they have recently had a fall and been hospitalised or need support with daily activities such as dressing or using stairs.

Nearly one third of people aged 65 years and older fall each year. Most falls occur in the home.

Lindy Clemson, Professor Emeritus at the University of Sydney, Australia was lead author of the review. She said: “Falls are very common among older people. They can cause serious injury or even death, but they are preventable. In this review we wanted to examine which measures could have the biggest impact on reducing falls among older people living at home.”

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Head injury associated with doubled mortality rate long-term – Study

Adults who suffered any head injury during a 30-year study period had two times the rate of mortality than those who did not have any head injury, and mortality rates among those with moderate or severe head injuries were nearly three times higher, according to new research from the Perelman School of Medicine at the University of Pennsylvania, published in JAMA Neurology.

In the United States, over 23 million adults age 40 or older report a history of head injury with loss of consciousness. Head injury can be attributed to a number of causes, from motor vehicle crashes, unintentional falls, or sports injuries. What’s more, head injury has been linked with a number of long-term health conditions, including disabilitylate-onset epilepsydementia, and stroke.

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Studies have previously shown increased short-term mortality associated with head injuries primarily among hospitalized patients. This longitudinal study evaluated 30 years of data from over 13,000 community-dwelling  participants (those not hospitalized or living in nursing home facilities) to determine if head injury has an impact on mortality rates in adults over the long term.

Investigators found that 18.4 percent of the participants reported one or more head injuries during the study period, and o those who suffered a head injury, 12.4 percent were recorded as moderate or severe. The median period of time between a head injury and death was 4.7 years.Death from all causes was recorded in 64.6 percent of those individuals who suffered a head injury, and in 54.6 percent of those without any head injury. Accounting for participant characteristics, investigators found that the mortality rate from all-causes among participants with a head injury was 2.21 times the mortality rate among those with no head injury.

Further, the mortality rate among those with more severe head injuries was 2.87 times the mortality rate among those with no head injury.“Our data reveals that head injury is associated with increased mortality rates even long-term. This is particularly the case for individuals with multiple or severe head injuries,” explained the study’s lead author, Holly Elser, MD, PhD, MPH a Neurology resident at Penn. “This highlights the importance of safety measures, like wearing helmets and seatbelts, to prevent head injuries.”Investigators also evaluated the data for specific causes of death among all participants.

Overall, the most common causes of death were cancers, cardiovascular disease, and neurologic disorders (which include dementia, epilepsy, and stroke). Among individuals with head injuries, deaths caused by neurologic disorders and unintentional injury or trauma (like falls) occurred more frequently.When investigators evaluated specific neurologic causes of death among participants with head injury, they found that nearly two-thirds of neurologic causes of death were attributed to neurodegenerative diseases, like Alzheimer’s and Parkinson’s disease.

These diseases composed a greater proportion of overall deaths among individuals with head injury (14.2 percent) versus those without (6.6 percent).

“Study data doesn’t explain why the cause of death in individuals with head injuries is more likely to be from neurodegenerative diseases, which underscores the need for further research into the relationship between these disorders, head injury, and death,” said Andrea L.C. Schneider, MD, PhD, an assistant professor of Neurology at Penn.

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Serious falls are a health risk for adults UNDER 65

As a senior citizen I am well aware of the danger of falls for my age group The Natiional Council on Aging reports: “Falls are the leading cause of fatal and non-fatal injuries for older Americans. Falls threaten seniors’ safety and independence and generate enormous economic and personal costs.”

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So, I was surprised to learn that adults UNDER 65 were also very much at risk for falls.

Adults who take several prescription medications are more likely to experience serious falls, say Yale researchers and their co-authors in a new study. This heightened risk can affect middle-aged individuals — a population not typically viewed as vulnerable to debilitating or fatal falls, the researchers said.

To identify factors that put adults at risk for serious falls, the research team used patient data from the Veterans Aging Cohort Study (VACS), a national study of individuals who receive care through the Veterans Health Administration (VA). They identified 13,000 fall cases and compared them to controls of similar age, race, sex, and HIV status. The fall risk factors included prescription medication use, and alcohol and illegal drug use.

The researchers found that falls were a problem for middle-aged patients. “Providers typically think about falls in people over age 65. But these people were primarily in their 50s and falls were an important concern,” said Julie Womack, lead author and associate professor at Yale School of Nursing.

The study also noted that the simultaneous use of multiple medications, known as polypharmacy, plays a significant role in serious falls among patients who are HIV positive and those who are not. The researchers examined HIV status because people treated for HIV take several medications and often at a younger age.

Medications that were associated with serious falls included those commonly used to treat anxiety and insomnia (benzodiazepines), as well as muscle relaxants and prescription opioids.

Another important finding is the role of alcohol and illegal drug use in falls, Womack said.

The study suggests that programs designed to prevent serious falls in older adults may need to be modified to address risks for middle-aged adults. “Fall risk factors are highly prevalent in the Baby Boomer generation more generally. The next step is to look at interventions for the middle aged,” said Womack. Those interventions could address drinking and illicit drug use in addition to polypharmacy. “When we’re thinking about fall prevention programs we have to think about alcohol and substance use. We need to help individuals cut back.”

Reducing falls in middle-aged and older adults is vital because falls contribute to increased risk of injuries, hospitalizations, and death, said Womack.

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Consider Tai Chi …

I have had great success with yoga over the years, but tai chi comes heavily recommended by people whose opinions I respect. I took some classes in it and enjoyed them, but never felt as totally exercised as I did with yoga. Herewith a breakdown of this gentle martial art.

Tai chi is a non-competitive martial art known for its self-defense techniques and health benefits. As a form of exercise, it combines gentle physical exercise and stretching with mindfulness.

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Research has produced mixed results but appears to show that tai chi can improve balance control, fitness, and flexibility, and might cut the risk of falls in older people.

Tai chi also appears to reduce pain and the symptoms of depression in some cases.

The martial art is an ancient Chinese tradition that has evolved over centuries. To its advocates, it has become a means of alleviating stress and anxiety, a form of “meditation in motion.” Its supporters claim that it promotes serenity and inner peace.

It is safe for people of all ages, as it does not put too much stress on the muscles and joints.

This article explores the documented evidence for the benefits of tai chi.

Benefits

Various research suggests the benefits of tai chi might include improved balance, pain management, and cognitive function in people with and without chronic conditions.

Other possible benefits include improved sleep quality and an enhanced immune system. Continue reading

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Falls lead to declines in seniors

Eat less; move more; live longer remains the mantra of this blog. Incredibly, as important as these factors are, as we age, the move more factor takes on added significance. Seniors with mobility problems can be more vulnerable than those without them. Mobility problems can come from a sedentary lifestyle as well as heavy medication.

More than half of elderly patients (age 65 and older) who visited an emergency department because of injuries sustained in a fall suffered adverse events – including additional falls, hospitalization and death – within 6 months. The results of a study examining how risk factors predict recurrent falls and adverse events were published online in Annals of Emergency Medicine (“Revisit, Subsequent Hospitalization, Recurrent Fall and Death within 6 Months after a Fall among Elderly Emergency Department Patients“).

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“Our study shows an even higher rate of adverse events than previous studies have,” said lead study author Jiraporn Sri-on, MD, of Navamindradhiraj University in Bangkok, Thailand. “Patients taking psychiatric and/or sedative medications had even more adverse events. This is concerning because these types of drugs are commonly prescribed for elderly patients in community and residential care settings.” Continue reading

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Important Aspects of Aging Well – Harvard

I write a lot about diet, exercise and  weight loss, but it’s no accident that part of the title of this blog is ‘living past 100.’ That’s really the reason for the diet, exercise and weight loss posts – so we can live longer and have full use of our physical as well as mental abilities.

So, I was most pleased to see Harvard HEALTHbeat reporting on the logistical aspects of aging well.

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“You’re probably already doing a lot to ensure that you stay in good health and are able to enjoy your later years: eating right, exercising, getting checkups and screenings as recommended by your doctor. But it also makes sense to have some contingency plans for the bumps in the road that might occur.”

 

1.    Adapt your home. Stairs, baths, and kitchens can present hazards for older people. Even if you don’t need to make changes now, do an annual safety review so you can make necessary updates if your needs change.
2.    Prevent falls. Falls are a big deal for older people — they often result in fractures that can lead to disability, further health problems, or even death. Safety precautions are important, but so are exercises that can improve balance and strength.
3.    Consider your housing options. You might consider investigating naturally occurring retirement communities (NORCs). These neighborhoods and housing complexes aren’t developed specifically to serve seniors — and, in fact, tend to host a mix of ages — but because they have plenty of coordinated care and support available, they are senior-friendly.
4.    Think ahead about how to get the help you may need. Meal preparation, transportation, home repair, housecleaning, and help with financial tasks such as paying bills might be hired out if you can afford it, or shared among friends and family. Elder services offered in your community might be another option.
5.    Plan for emergencies. Who would you call in an emergency? Is there someone who can check in on you regularly? What would you do if you fell and couldn’t reach the phone? Keep emergency numbers near each phone or on speed dial. Carry a cellphone (preferably with large buttons and a bright screen), or consider investing in some type of personal alarm system.
6.    Write advance care directives. Advance care directives, such as a living will, durable power of attorney for health care, or health care proxy, allow you to explain the type of medical care you want if you’re too sick, confused, or injured to voice your wishes. Every adult should have these documents.
To read further on Harvard’s suggestions, check this.

Tony

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