INFORMATION ON FALLS

Risk factors   |   Key physical factors   |   Use of medications
Social/lifestyle factors   |   Environmental factors   |   Testing your balance

When we are young it is easy to blame sudden falls on environmental factors, such as loose carpets, slippery floors, uneven surfaces, or just plain recklessness! But as we grow older, a sudden fall can raise the question that something might be wrong. Loss of balance and mobility are not inevitable as we grow older, but sudden falls in older individuals are a concern because the incidence of balance problems is known to increase significantly with age. The risk for serious injury increases as well. The good news is that many individuals at risk for falls can be identified and helped.
 

Risk factors

So how do you know if someone is at risk for falling? There are several known risk factors, both related to yourself (physical fitness/ailments, psychological and social factors) and your environment (the surfaces you walk on, obstacles, lighting, etc.), that can increase your susceptibility to falling. Some common indications include symptoms of dizziness or unsteadiness, taking one or more medications, a recent period of bed rest or inactivity, loss of strength or feeling in the legs or feet, or a loss of confidence in your ability to get around. However, there are many other subtle indicators that you or your physician may not even be aware that you have. To complicate the matter, falls are not typically the result of a single cause or risk factor. More often, they are the net result of a combination of factors.
 

Key physical factors

Balance problems and dizziness are obvious indicators that someone is at a higher risk for falling. It may not always be obvious that balance is diminished, as unsteadiness may be caused by a number of smaller physical ailments that alone would not cause a person to fall. However, the combination of relatively minor problems can be a significant risk for falling. Other key physical factors include reduced muscle strength in the legs and painful or unstable ankle, knee and hip joints, which can impact your ability to support yourself and quickly recover from sudden changes to the surface you are walking on. Limited range of motion and flexibility can make stepping over obstacles and walking on uneven or inclined surfaces more difficult. Weakness, slowing, loss of feeling or coordination as a result of a stroke or degenerative disease, such as Parkinson's can have a significant impact on balance and mobility. Even arthritis can be an indicator of fall risk because it can result in poor range of motion, reduced muscle strength, and a loss of sensation at the affected joints. Poor vision and a history of ear infections or inner ear disorders are also risk factors. While having one or two of the above risk factors will not necessarily cause someone to fall, the likelihood of falling increases with the number of risk factors that are present.
 

Use of medications

The use of multiple prescriptions or over the counter drugs can also increase a patient's risk for falling. It is always important to understand the side effects of any medication a patient may be taking, both alone and in combination. The most common drugs implicated in fall risk are diuretics, hypotensives, anticoagulants, hypnotics, psychotropics and laxatives. Drugs to treat high blood pressure or heart ailments can cause dizziness and sedatives or drugs to aid in sleeping can impact a patient's ability to maintain balance.
 

Social/lifestyle factors

You might think that someone who leads a relatively inactive lifestyle would have less chance of suffering from a fall because they are not putting themselves at risk. Inactivity, however, is an important risk factor for falling. Prolonged inactivity can actually lead to loss of muscle strength, joint range of motion, and your ability to quickly react to a sudden slip or stumble. Unfortunately, fear of falling itself can cause someone to be at higher risk as they get stuck in a vicious cycle of immobility and progressive de-conditioning weakness from self-imposed mobility restrictions.
 

Environmental factors

A patient's home and physical surroundings are filled with things that may not be notice. Rugs and bathmats, uneven or loose steps, cupboards or shelves that are either too high or too low to reach easily, and dim lighting in rooms and hallways are things he or she may have lived with for many years. These "innocent" things, however, can be detrimental to someone whose ability to quickly recover from a slip or stumble is already compromised.
For example, if a patient has limited range of motion or balance problems, he or she may not raise the foot as high as the average person when taking a step, which makes it more likely to trip over a wrinkle in a rug. The patient may have numbness in your legs or feet and will have more difficulty being able to sense when stepping onto a slippery or unstable surface. Or possibly the patient has poor vision and may need more light to be able to see objects clearly. Again, none of these risk factors alone will necessarily cause a fall. It is the combination of risk factors, both physical and environmental, that increases the likelihood that someone will suffer a fall.
 

Testing balance

To help determine if someone may be headed for a fall, a patient may answer a series of balance screening questions and/or stand on a balance platform for an evaluation all of which are provided by Vertigon. There are numerous clinical tests that are easily performed that can detect if you have a balance problem. Then there are tests that can tell what is causing the problem. The great news is that if you have patients that do have balance problems, there is help available. There are many things you can do to reduce your patients risk for falling in your practice or health facility. Vertigon Fall Prevention Services provides the latest, most effective tools available to diagnose and treat balance disorders. Contact us for more information on how you can implement an effective fall prevention program in your office or facility.