What’s the Best Way to Prevent Falls in Older Adults?

Journal of the American Geriatrics Society Research Summary

An international team of experts compared practices that research has shown to help older adults prevent falls. Their new study, published in the Journal of the American Geriatrics Society, suggests that:

  • Exercise is the most effective method for decreasing the rate of falls in adults aged 65 and older who live independently. It is especially effective in adults aged 75 and older.
  • Exercise and a basic falls risk assessment by your healthcare provider can reduce your risk of breaking bones in a fall. In a falls assessment, your healthcare provider asks you about whether you’ve fallen, the details of the fall, and whether your home environment contributed to the fall. They also evaluate how well you walk and move around, along with your balance and other walking-related issues.

These strategies can also help prevent falls:

  • Using assistive technology and devices. These can include canes, walkers, and devices that can call for help at the touch of a button.
  • Making homes safer by:
    • removing clutter, throw rugs, and other falling hazards
    • improving lighting
    • installing grab bars
    • making other home improvements.

Falls: A Serious Health Problem for Older Adults

Falling, or accidentally and unexpectedly landing on the ground, usually happens in familiar environments while you are doing your normal, daily activities. You may fall when something pushes you, you trip, you lose consciousness (from a seizure, stroke, or other health problem), or you are experiencing the symptoms of a new illness.

Falls have serious consequences. One out of five falls does causes a serious injury, such as a broken bone or a head injury.[1] In older adults, they are the number one cause of hospital admissions for injuries. The older you are, the more likely falls are to threaten your ability to live at home and increase your risk of an early death.

Falls are very common among older adults, especially those who have multiple chronic conditions. An older person falls every second of the day, and one out of three older adults living at home falls every year.

Why the Researchers Studied Fall Prevention Strategies

Falls are such a big problem for older adults that many researchers have studied ways of preventing them. In order to get the big picture of what works best to prevent falls, the researchers of this study did what is called a systematic review and meta-analysis. This means that the researchers looked at the results of multiple studies all at once.

Most of the studies they looked at evaluated programs that used more than one strategy at the same time to prevent falls. Researchers say this study is the first to look at how effective the individual falls prevention strategies are when they are examined separately, instead of together. Understanding and comparing the effects of each strategy can make it easier for healthcare professionals to offer older adults personalized help.

Earlier studies have also failed to include people over the age of 75 and older adults with multiple chronic conditions. Because people in these groups have an especially high risk of falling, it is important to learn more about which falls prevention methods are most effective for them.

What the Researchers Learned

The researchers examined 192 studies that included nearly 100,000 older adults who live independently. Of those studies, 128 included adults between the ages of 75 and 84 years old.  Eleven of the studies included people 85 or older. The studies compared the effects of 63 fall prevention strategies—some individual strategies and some combinations of strategies—to the effects of the care the participants usually received.

Researchers found that that exercise is the most effective individual strategy for decreasing the rate of falls and number of falls in adults aged 65 and older who live independently. It seems to be especially effective in adults aged 75 and older. Strategies that work in combination include exercise, falls risk assessments, the use of assistive devices, and making changes to your home that make it safer.

Study findings also suggest that older adults who exercise and have had falls risk assessments may be less likely to break bones if they fall.

Study Limitations

Over half the studies that the researchers looked at used methods that may have caused biased results.

What This Study Means for You

If you do only one thing to prevent falls and fall-related broken bones, make it exercise.

This summary is from “Interventions for preventing falls and fall-related fractures in community-dwelling older adults: a systematic review and network meta-analysis.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Lauren Dautzenberg, MD, MSc; Shanthi Beglinger, MD, MBiolSci; Sofia Tsokanid, MSc; Stella Zevgitid, PhD; Renee CMA Raijmanna, MD, MSc; Nicolas Rodondib, MD, PhD; Rob JPM Scholtene, MD, PhD; Anne WS Rutjesc, PhD; Marcello Di Nisiog, MD, PhD; Marielle Emmelot-Vonka, MD, PhD; Andrea C Tricco, PhD; Sharon E Straush, MD, MSc; Sonia Thomash, MSc; Lisa Bretagneb, MD, MSc; Wilma Knola, MD, PhD; Dimitris Mavridis, PhD; and Huiberdina L Koeka, MD, PhD.

[1] https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

COVID-19: My City is Reopening. How Can I Protect Myself?

You may be living in an area where local officials have decided it’s time to begin loosening restrictions that were put in place to slow the spread of COVID-19. While we can’t reduce our chances of becoming infected with the virus to zero, we can lower our risks and help reduce the coronavirus’ spread as restrictions are lifted.

If you’ve been diagnosed with COVID-19, have symptoms, or have been in close contact with someone who has COVID-19, it is important to stay home and away from other people. When can you leave home and be around other people? That depends on different factors for different situations. Follow the Centers for Disease Control and Prevention (CDC)’s recommendations for your circumstances.

As your area starts to reopen, your risk for contracting COVID-19 will be tied to several different factors. In general, the closer and longer you interact with others, the higher your risk of catching or spreading COVID-19. Ask yourself these questions: Continue reading

Five Things to Know Right Now About Coronavirus Disease (COVID-19)

You may have heard a lot recently about “coronavirus” or COVID-19, the virus responsible for a current global outbreak. Scientists and health experts are still learning more, but here are five things to know to keep yourself and those you care for safe and informed.

1. What is COVID-19?

COVID-19 is a type of coronavirus, which is a family of viruses common in humans and many different animals. Viruses in this family can cause respiratory illnesses ranging from the common cold to more severe diseases. Cases of COVID-19 in particular can be mild, but others can be more severe and occasionally deadly—especially for those living with other chronic health conditions.

2. Where is it?

Click here for a list of countries impacted by COVID-19.

3. What are the symptoms and what should I do if I experience them?

In general, COVID-19 causes a respiratory illness that ranges from mild to severe, though for some it can be deadly. Symptoms, which usually appear 2 to 14 days after someone gets infected, can include:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

If you have these symptoms, call your healthcare professional first, before visiting an office. Your healthcare professional will determine if your symptoms match COVID-19 and whether you should be tested. Also contact your healthcare professional if you have been in close contact with a person known to have COVID-19 and/or have recently traveled to an area where COVID-19 cases have occurred.

If you develop emergency warning signs such as difficulty breathing, call 911 immediately. Let the 911 operator know that you may have COVID-19 symptoms.

4. How does it spread?

Scientists are still learning more, but coronavirus appears to spread person-to-person during close contact with someone infected, specifically from respiratory droplets when that person coughs.

It appears COVID-19 may also be able to spread on household surfaces and in the air, so it’s always best to exercise as much caution as possible while scientists learn more.

5. How can I protect myself and others?

For now, the CDC recommends that older adults or those with chronic medical conditions consider postponing travel, especially to areas impacted by COVID-19.

Additionally, the CDC recommends everyone follow these everyday practices:

  • Stay at home as much as possible and avoid crowds or poorly ventilated areas.
  • Make sure you have access to several weeks of medications and supplies in case you need to stay home for prolonged periods of time.
  • Stay home when you are sick.
  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Wash your hands often with soap and water (or an alcohol-based hand sanitizer with at least 60% alcohol) for at least 20 seconds. Soap up and then sing the “Happy Birthday” song twice before you rinse off the soap. You should especially wash your hands after going to the bathroom; before eating; after blowing your nose, coughing, or sneezing; and after encountering anyone who is or may be sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If a tissue isn’t readily available, sneeze or cough into your elbow to reduce the risk of spreading infection with your hands.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning product.

Stay Empowered, Stay Informed

Physical and Mental Exercise Lower Chances for Developing Delirium After Surgery

Journal of the American Geriatrics Society Research Summary

After having surgery, many older adults develop delirium, the medical term for sudden and severe confusion. In fact, between 10 and 67 percent of older adults experience delirium after surgery for non-heart-related issues, while 5 to 61 percent experience delirium after orthopedic surgery (surgery dealing with the bones and muscles).

Delirium can lead to problems with thinking and decision-making. It can also make it difficult to be mobile and perform daily functions and can increase the risk for illness and death. Because adults over age 65 undergo more than 18 million surgeries each year, delirium can have a huge impact personally, as well as for families and our communities.

Healthcare providers can use several tools to reduce the chances older adults will develop delirium. Providers can meet with a geriatrician before surgery, review prescribed medications, and make sure glasses and hearing aids are made available after surgery (since difficulty seeing or hearing can contribute to confusion). However, preventing delirium prior to surgery may be the best way to help older adults avoid it.

A team of researchers from Albert Einstein College of Medicine designed a study to see whether older adults who are physically active before having surgery had less delirium after surgery. The research team had previously found that people who enjoy activities such as reading, doing puzzles, or playing games experienced lower rates of delirium. The team published new findings on physical activity in the Journal of the American Geriatrics Society.

Continue reading

Physical Therapy in the Emergency Department after a Fall May Help Reduce Future Fall-Related Visits to the Emergency Department

Journal of the American Geriatrics Society Research Summary

Falls are the leading cause of illness and death among Americans aged 65 and older. In 2014, some 2.8 million older adults visited the emergency department (ED) for a fall-related injury. And over time, the ED visit rate for falls among older adults has grown to 68.8 per 1,000 older adults (as of 2010).

Older adults who visit the ED for a fall are at high risk for both revisiting the ED and dying. In fact, some estimates show that 25 percent of older adults visiting the ED for a fall returned for at least one additional fall-related visit. Fifteen percent of those older adults died within the following year.

Because so many older adults visit an ED due to falls, many experts see an opportunity for EDs to play a role in reducing future falls among older adults who are at high risk.

In a new study, published in the Journal of the American Geriatrics Society, researchers explored whether older adults who received physical therapy (PT) services while in the ED for a fall experienced fewer fall-related repeat visits to the ED.

The research team used Medicare claims data representing Medicare beneficiaries from across the country. The information examined differences in 30-day and 60-day ED repeat visit rates among older adults who visited the ED for a fall and who received PT services in the ED. The researchers compared that to older adults who did not receive PT services in the ED after a fall. Continue reading