Falls are a significant public health issue in Australia, particularly among the elderly population. According to the Australian Institute of Health and Welfare, falls were the most common cause of injury-related hospitalisations in 2020–2021, with more than 222,000 cases reported. The risk of falling increases significantly with age, with about 30% of people aged 65 and over experiencing at least one fall each year. For those aged 85 and over, this figure rises to 50%.

Risks of Falls

The risk factors for falls include age-related physiological changes such as decreased muscle strength, balance, and vision, as well as chronic health conditions like arthritis, diabetes, and cardiovascular diseases. Cognitive impairments, such as dementia, also plays a critical role in increasing fall risk. Other external factors include environmental hazards such as poor lighting, slippery floors, and obstacles in walkways. Additionally, the use of multiple medications, particularly those affecting the central nervous system, can exacerbate these risks. It's estimated that more than 25% of falls in the elderly are linked to medication side effects.

Complications from Falls

Falls can lead to a wide range of complications, both physical and psychological. The most common and severe injuries resulting from falls include:

1. Fractures: Hip fractures are particularly concerning, with approximately 95% of hip fractures in older adults being caused by falls. Recovery from a hip fracture often requires surgery and extensive rehabilitation, and many patietns may never regain their previous level of mobility.

2. Head Injuries: Falls are the leading cause of traumatic brain injuries in older adults. Even a mild head injury can have serious consequences, especially in individuals taking anticoagulants, which can lead to increased bleeding risks.

3. Fear of Falling: After a fall, many individuals develop a fear of falling again, leading to reduced physical activity and social isolation. This fear can further contribute to physical decline and increase the risk of future falls.

4. Hospitalisation and Loss of Independence: Falls are a leading cause of injury-related hospitalisations, often resulting in long stays and significant healthcare costs. The loss of independence due to injuries can lead to a decline in overall quality of life, with many individuals requiring long-term care or assisted living.

5. Mortality: Unfortunately, falls can be fatal, particularly when they result in severe head injuries or complications from fractures. In Australia, falls are responsible for around 5,000 deaths annually among those aged 65 years and over.

Preventative Measures for Falls

Preventing falls in older adults requires a proactive, multi-faceted approach that addresses both the physical and environmental factors contributing to fall risk. Here are some specific strategies that can be implemented:

1. Exercise Programs: Regular physical activity, particularly exercises focused on improving balance, strenght and flexibility, is one of the most effective ways to prevent falls. Strength training exercises help to maintain muscle mass and joint function, which are crucial for stability.

2. Home Modifications: Many falls occur at home, making it essential to assess and modify living spaces to reduce hazards. Key modifications include installing grab bars in bathrooms, using non-slip mats, ensuring that all areas are well-lit, removing loose rugs or clutter from walkways, and rearranging furniture to create clear, unobstructed paths. For those with mobility issues, using assistive devices like walkers or canes can also help prevent falls.

3. Medication Review: We can review medication regimes to identify drugs that might contribute to falls. Medications such as sedatives, antihypertensives, and antidepressants can cause side effects like dizziness, drowsiness, or orthostatic hypotension, increasing fall risk. Adjusting dosages or switching to safer alternatives in liasion with your doctor can mitigate these risks.

4. Vision and Hearing Checks: Regular vision and hearing assessments are vital, as impaired vision or hearing can contribute to falls. Ensuring that individuals have the correct prescription glasses and hearing aids, if needed, can help them navigate their environment more safely.

5. Footware and Foot Care: Proper footwear is crucial in preventing falls. Shoes should have non-slip soles, be well-fitting, and provide adequate support. Regular foot care, including managing conditions like bunions or neuropathy, also plays a role in maintaining stability and reducing fall risk.

6. Nutrition and Bone Health: Adequate nutrition, particularly sufficient intake of calcium and vitamin D, is essential for maintaining bone health and reducing the risk of fractures in the event of a fall. A diet rich in fruits, vegetables, lean proteins, and whole grains supports overall health and can prevent the muscle weakness and bone fragrility that increase fall risk.

7. Community Support and Education: Engaging in community-based fall prevention programs can provide older adults with valuable information and support. These programs often include workshops on fall prevention techniques, home safety assessments, and opportunities for social interaction, which can reduce isolation and encourage participation in regular physical activity.

8. Use of Assistive Technology: Advances in technology have introduced devices like wearable alert systems, which can detect falls and automatically notify caregivers or emergency services. These devices can be life-saving, especially for those living alone.

By implementing these strategies, the likelihood of falls can be significantly reduced, promoting greater independence and quality of life for older adults. The complications of falls can be serious.  Given that we know they affect a very significant proportion of older adults it is important to stop and give it some thought.

As always our pharmacist team are available to discuss this issue and provide further assistance.