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As you get older, the risk of falling increases and becomes more and more dangerous. A fall can be a real disadvantage for the health of a frail elderly person. In addition, seniors who die today are more numerous than 20 years ago. A recent study showed that more than 25,000 American adults aged 75 and over died from a fall in 2016, compared with more than 8,600 deaths in 2000, and the fatal death rate for this group of Age has nearly doubled.
But the risk of falling can be minimized, says Dr. Elizabeth Eckstrom, professor and head of geriatrics at Oregon Health & Science University. "Many older adults and many doctors think that falling is inevitable with age, but in reality this is not the case."
Lulu Garcia-Navarro and Luisa Torres of NPR spoke to Eckstrom about the most common causes of falls in the elderly and the best ways to prevent them.
This interview combines two separate conversations with Eckstrom and has been modified for clarity and length.
Do older people fall more than before? Or are there more seniors? Does anything else explain this increase?
I think it could be a bit of both. There are so many more seniors and there are probably better relationships than in the past. Seniors and doctors are starting to think a little more. I think our older adults are starting to [be more active]and it will also expose you to the risk of falling. I always tell people not to be sedentary to avoid falls. It's the worst thing you can do. You must be active and active, but being active allows you to put yourself in a position where you could fall.
In addition, I think one of the biggest problems with falls is that so many older adults are taking risky medications. Sleeping pills, analgesics, and most of the medications prescribed to older people for years have significantly increased the risk of falling. And if we could remove everyone from these pills, it would be very useful.
How do analgesics increase the risk of falling?
Analgesics have similar side effects [compared to] sleeping tablets. They can make you dizzy. They can confuse you. They can make you lethargic. They can keep you from being so sharp that you do not pay attention to uneven curbs or sidewalks.
Are there any other medications that seniors should know?
Yes, absolutely. There are many medications that go into a class called anticholinergics. It's the class that has cold medicine like Sudafed [and] medications to help control bladder problems like Detrol. All of these drugs are in this very dangerous anticholinergic class, [which] increases your risk of falling.
The other thing that a lot of older people take, these are pills for blood pressure. The management of blood pressure is a bit tricky [because] you do not want your blood pressure to be too high as this increases your risk of heart attack and stroke. But if you take too many pills for blood pressure, your blood pressure will be too low and you will feel dizzy and fall.
A study by the Centers for Disease Control and Prevention found that doctors generally failed to perform basic interventions to help prevent falls. Why do you believe that and how can doctors help?
Most primary care physicians do not have more than 15 minutes with a patient and they manage their diabetes, congestive heart failure, asthma – all these other health problems. And [they] do not recognize the importance of falls prevention in this setting. It takes a lot of work to help an older person reduce his risk of falling. You have to talk about glasses; you must make sure that they are wearing the right shoes; you have to make sure that they use an aid to the gait [like a cane or a walker] if they need it, and it all takes time.
The CDC has also done a remarkable job in putting in place a series of fall prevention measures as part of an initiative called STEADI (Ending Accidents and Deaths in Older People and Injuries). You can go to their website and find all kinds of useful information to help clinical teams, seniors and families reduce the risk of falling.
Can you remind us why the fall is so dangerous for the elderly?
About one-third of seniors who fall suffer some form of injury, many of which are hip fractures and head injuries. And these can be fatal, of course. The fear of falling is an extremely important thing, and many seniors who are falling off their activities for fear of the next fall. And, again, it's a bit of the worst thing to do, because you lose mobility, you get weaker and you do not move as much.
What are some of the interventions you have used that can help seniors?
You can do a lot of things. First of all, I tell everyone that you have to train for balance. Tai Chi is probably the best exercise to prevent falls, but it does not matter what works for you. And, interestingly, just walk do not Reduce your risk of falling. So, many doctors will say, "Just go out and walk 20 minutes a day to stay safe, it will help you stay healthy." The walk is excellent for your heart. it's good for your brain; it's great for many. But to really reduce the risk of falls, you need to do something specific to balance.
What makes tai chi a good exercise to prevent falls? And why not walk a good alternative?
Walking, it's somehow keeping you on a plane and not doing any kind of postural training. What is tai chi doing is that it gives you an increased area of postural stability, [which is] sort of your ability to stand in space. When you practice tai chi, you take a step forward, to the side; you spread your arms, you reach, you lean. And basically, it increases the size of your postural stability so you can catch up and not fall. You can be a little off and straight yourself.
Do you have any other tips on how seniors can prevent falls?
For most people, this is not a bad thing. It's not just your balance, or it's not just your vision, or it's not just a pill that you take. If someone wants to reduce his risk of falling, he must really think about all the ways: make sure you wear the right shoes; use a walker if you need it get out of these risky drugs. It is really important to take into account all these small details so that your risk of falling is as low as possible. I encourage people to work really hard on it. It's worth it.
Francesca Paris and Ed McNulty produced and edited this story for broadcast