Reducing Fall Risk
by David Dunaief
Aug 28, 2019 | 8466 views | 0 0 comments | 689 689 recommendations | email to a friend | print
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
When we are young, falls usually do not result in significant consequences. However, falls are a serious concern for older patients, where consequences can be devastating.

They can include brain injuries, hip fractures, a decrease in functional ability and a decline in physical and social activities. Ultimately, falls can lead to loss of independence. Of those over age 65, between 30 and 40 percent will fall annually.

What can increase the risk of falls?

A personal history of falling in the recent past is the most prevalent contributor to fall risk. However, age, being female, and using drugs, like antihypertensive medications used to treat high blood pressure and psychotropic medications used to treat anxiety, depression and insomnia, also contribute.

Chronic diseases, including arthritis, as an umbrella term, can also contribute. Circumstances that predispose us to falls also involve weakness in upper and lower body strength, decreased vision, hearing disorders and psychological issues, such as anxiety and depression.

How do we prevent falls?

Fortunately, there are ways to modify many risk factors and ultimately reduce the risk of falls. Of the utmost importance is exercise.

But what do we mean by exercise? Exercises involving balance, strength, movement, flexibility and endurance, whether home based or in groups, all play significant roles in fall prevention.

Many of us in the Northeast suffer from low vitamin D, which may strengthen muscle and bone. This is an easy fix with supplementation.

Footwear also needs to be addressed. Nonslip shoes, if recent winters are any indication, are of the utmost concern. Inexpensive changes in the home, like securing area rugs, can also make a big difference.

Medications that exacerbate fall risk

A number of medications may heighten fall risk. As I mentioned, psychotropic drugs top the list. They also top the list of the best-selling drugs.

Also, a study showed an increase in fall risk in those who were taking high blood pressure medication. Surprisingly, those who were on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase.

Why is exercise critical?

A meta-analysis of a group of 17 trials showed that exercise significantly reduced the risk of a fall. Even more impressive was a 61 percent reduction in fracture risk.

Remember, the lower the fracture risk, the more likely you are to remain physically independent. Thus, the author summarized that exercise not only helps to prevent falls, but also fall injuries.

Unfortunately, those who have fallen before, even without injury, often develop a fear that causes them to limit their activities. This leads to a dangerous cycle of reduced balance and increased gait disorders, ultimately resulting in an increased risk of falling.

What specific types of exercise are useful?

Many times, exercise is presented as a word that defines itself. In other words, just do any exercise and you will get results. But some exercises may be more valuable or have more research behind them.

Tai chi, yoga and aquatic exercise have been shown to have benefits in preventing falls and injuries from falls.

A six-month trial of 108 postmenopausal women showed that those who did an aquatic exercise program had a significant improvement in the risk of falls. Results showed a reduction in the number of falls from a mean of 2.00 to a mean of 0.29, along with a 44 percent decline in the number of patients who fell.

Thus, our best line of defense against fall risk is prevention. Does this mean stopping medications? Not necessarily. But for those 65 and older, or for those who have “arthritis” and are at least 45 years old, it may mean reviewing your medication list with your doctor.

Before considering changing your medications, review the risk-to-benefit ratio with your physician. The most productive way to prevent falls is through lifestyle modifications.
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