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Older adults are far more likely to be seriously, even fatally, injured in falls than younger adults. In fact, more than 1.5 million adults aged 65 and older need emergency medical care for injuries due to falls each year. And over 4,700 older people die of these injuries each year.

Age- and health-related changes in vision, balance, sensation, reaction time, and strength can all increase the chance of falls. Based on these findings, researchers have developed tests, known as a physiological profile assessment (PPA), to determine how likely it is that a person will fall, and identify what puts him or her at risk of falling.

New Research in the Journal of the American Geriatrics Society

To see whether they could develop effective individualized fall prevention programs based on older adults' PPA scores, researchers at the University of New South Wales recently studied a group of 620 volunteers who were aged 75 years or older.

At the start of the study, the researchers evaluated each volunteer's risk of falling using the PPA. They then randomly assigned each volunteer to one of three groups for 12 months.

For everyone in the first group, known as the extensive intervention group (EIG) , the researchers developed an individualized fall prevention plan, based on his or her PPA:

• Those who had balance problems, muscle weakness, or slowed reaction time were assigned exercise classes designed to improve their balance, strength, or reaction time.
• Those with vision problems were sent to eye specialists, and, if necessary, got new glasses, cataract surgery, or other vision treatments.
• And those whose with decreased sensation (or ability to feel) in their legs -something that can also contribute to falls -were taught to take certain precautions, such as using a walking stick or wearing shoes with low heels and firm soles, to compensate for this.

Everyone in the second group, the minimal intervention group (MIG), got brief advice on falls prevention. And those in the third group, the control group (CG), got no intervention.

During the 12-month study period, the researchers kept track of any falls the volunteers had. Half way through the trial (at six months), the researchers again evaluated the volunteers' risks of falls using the PPA.

The researchers found that volunteers in the EIG saw their risk of falls drop the most during the study period. Those in the MIG saw their risk of falls drop to an intermediate extent. And volunteers in the control group saw the smallest drop in their risk of falls.

Surprisingly, however, those in the EIG didn't have fewer actual falls than those in the other two groups. Even the extensive intervention wasn't effective enough to prevent falls, the researchers report. This could have been due to a number of things - the exercises intended to improve balance, strength and reaction time may not have been appropriate or adequate, and measures to improve vision may not have been good enough, they note.

Other studies have found that interventions such as physical therapy and group exercise programs designed to lower risk of falls can be effective in preventing falls.

"Improvements in designing and implementing interventions (based on PPA profiles) are therefore required," the researchers conclude.

What Should I Do?

Let your doctor know if you're having trouble seeing, or problems with balance, muscle weakness, slowed reaction time, or other health problems that can boost your risks of falls. You should also let your physician know if you've had any falls recently. As the researchers who conducted the study note, there are interventions that can help prevent falls. Your doctor can help you decide which are best for you.

For more information on falls, visit http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=21.

The summary above is from the full report titled, "The Effect of an Individualized Fall Prevention Program on Fall Risk and Falls in Older People: A Randomized, Controlled Trial." It is in the July 2005 issue of the Journal of the American Geriatrics Society (Volume 53, Issue 8, pages 1296-1304). The report is authored by Stephen R. Lord, PhD; Anne Tiedemann, BSc, GradDip; Kirsten Chapman, BA, BSc; Bridget Munro, BSc (Hons); Susan M. Murray, M Gerontology, Dip Remed Gymnast Recreat Ther; and Catherine Sherrington, PhD.