The People's Perspective on Medicine

How Can Elderly People Avoid Falls?

Exercise to improve balance and strength reduced injury from falls, while vitamin D supplements had no effect.

A fall can be devastating for an older person. Breaking a hip is associated with a high risk of premature death as a result of complications.

Fall Prevention

That’s why doctors are interested in ways to help patients prevent falls. A two-year, placebo-controlled randomized study was disappointing in this respect.

The investigators assigned 400 elderly Finnish women to one of four groups: placebo pill and no exercise, vitamin D pill and no exercise, vitamin D and exercise, and placebo and exercise. The expectation was that either vitamin D or exercise or both would reduce the number of falls these women recorded in their research diaries. The pills provided 800 IU of vitamin D daily.

Exercise Associated with Less Harm

Exercise did improve balance and muscle strength, and the women who exercised were less likely to harm themselves if they fell. Vitamin D improved bone strength, but did not affect physical function. The research underscores the importance of exercise, even as people grow older.

JAMA Internal Medicine, online March. 23, 2015

The researchers did not discuss the role of medications such as sleeping pills or anti-anxiety agents in contributing to falls in older people, but this is a risk that concerns us.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I am 78. live in a townhouse with steps. I use a walker outside as I have had back and knee surgery, and a cane indoors. I put a railing on both sides of stairs. a chair and small railing in my shower, keep a grab it in every room-including next to my bed..in case i drop my book ..a small foot stool in kitchen that I can roll around, but stops as soon as I very carefully step on it. I never move quickly as I know, from watching my friends and previously, my mom, how easy it is to lose your balance. I walk a frisky terrier on a leash whenever the weather cooperates, but know if there is ice..forget it. I put an apparatus on my cane that has prongs so that when i go shopping I can move this on the cane to prevent slipping. I think ahead because frankly, I am petrified of falling. it isn’t easy always planning, but it sure saves my independence..as I do not want to be afraid to venture out or stuck home.

Consider eyeglasses in falls. I wear, on occasion, bi-focals, and when looking down at walkway steps or such lose focus and mis-step. Stepping off a grocery store curb, for me requires special care, often I step sideways.

Since we were soon to be 78, we decided to redo our small bathroom. We enlarged the narrow door, so my walker fit thru. (I have knee blow-outs and foot surgeries meant the walker on hand). We put a walk-in shower with lots of bars. That was in Sept.; I had 2 falls, no injuries, but at a dr.’s office in Jan., fell from a high chair, broke my right hip, hurt a nerve in that arm and went thru 2 rehab places and still on out-patient therapy. I hope to drive again and walk, but the accident turned my pelvis so my right leg is shorter now. Hope to get that fixed next. I take meds for things like neuropathy but never had good balance. I mall-walked every day for an hour and hope to get back to it. I’m probably a bit underweight but that helps my terrible knees. Good luck – lotsa rust in these golden years.

Please tell me why the picture in the upper left-hand corner of this article about “elderly people falling” is of an attractive woman who is probably in her forties or fifties (at most). Yours isn’t the only column that does this, but it detracts from the credibility of what you are attempting to demonstrate. How about using more realistic pictures?

Does “elderly” describe an age range, or a set of physical conditions perhaps combined with an age range? As an older person, I don’t feel elderly yet, and am annoyed that sometimes “elderly” describes people over 55 years of age. I don’t think it’s a good category name to use without specifying with each use what it means.

I agree that exercise and nutrition are important in preventing falls for elderly. Perhaps we could expand the concept to include safety in the home for the elderly that have lost physical capacity/function. Let’s just say they have changed but the environment around them has remained static. How can that environment (the home) be changed so that they can age in place more safely? The awareness of how our homes can be modified for safety, comfort and convenience remains low. Instead of looking at these options we tend to wait for an accident that eventually ends up with placement in a nursing home or assisted living community. Since many folks at this age either own or have substantial equity in their home why not consider investing in a barrier free shower or some other cogent home modification before a fall or other accident occurs? The cost / benefit seems logical – everyone would like to stay in their home as long as possible.

I was puzzled at why my mother-in-law who will be 100 in May felt so unsteady on her feet. It would be easy to say that it is her age but her health is really quite good. She only takes one prescription and a small dose at that for blood pressure. I took her to have her eyes examined because she does need glasses to read and the prescription had not been changed for 8 years. I learned that she is almost totally blind in one eye now. At her age, it is much harder to adjust to only seeing out of one eye. The other eye is 20/60 which the optometrist said is very good for her age. If I close one eye my balance and equilibrium is quite impaired. My point, maybe the tendency to fall could be a change in vision of our aged person. It should be checked out.

I’m wondering if body weight was a factor in this cited study as well. I’ve been hearing that some medical professionals are now advocating that older adults be in the “overweight” category on BMI charts. This means they’ll have “padding” that protects if there is a fall, lessening the chance of major injury. Secondly, extra “padding” provides fighting weight if one gets ill.

Also, medical people are finding in their zeal to keep blood pressure DOWN, the medication to do that is actually making a patient more lightheaded….. thus, falls. They’re reassessing whether the risk of falling outweighs the risk of higher blood pressure.

your comments seem to justify being overweight as a ‘protection’ in the event of a fall. If that is your intent, I doubt if this is factual, in that excess ‘padding’, as you put it, may contribute to lack of maintaining balance, increasing the likelihood of falls and in general, contribute to less than ideal health.

I just turned 78 and I walk my dog every day unless it’s icy or pouring rain. My dog sometimes sees a cat before I do and has pulled hard to chase it. I think she has pulled me down at least 8 times in the last 5 years (onto dirt/grass). I guess I just know how to roll because I have, so far, never been hurt at all.

Sounds like you allow too much lead on the leash. Shorten up the leash so that your dog is standing right By your side not ahead of you. You’ll have a lot more control.

Falls as we get older. I faced this problem about seven years ago as I entered my sixties. I would lose balance and was unable to right myself in order to prevent falling. It did not make sense to me that I was unable to stop falling. However I had entered into an activity that in time prevented the lose of balance from even happening. I use to have about ,hmmmm can not even remember how many falls per month. Maybe three or four. After engaging in this activity fro a few months I realized I had not lost my balance in months. If I tripped I was able to recover.
The activity that I had engaged in was learning to teach my dogs and myself how to herd sheep. One of the activities of teaching this was to learn how to walk backwards facing the sheep. I was constantly tripping and falling into the soft grass and dirt. Then it became an easy thing to do to the point I am able to walk forward and without missing a beat turn and start walking backwards. This learning to walk backwards was the only new activity that preceded being able to remain upright after tripping or just no longer having a loss of balance for no good reason which was ending in a fall to the floor.
I will be 70 this year and I still have no loss of balance or falls in the house since starting herding activity and learning to walk backwards.. I eat out of the box and have always been active.
I believe that learning to walk backwards will improve peoples balance and result in no more or less falls do to loss of balance.

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