Falling in the elderly

The article was written by Specialist Doctor I Vo Khac Khoi Nguyen - Orthopedic surgeon, General Surgery Department - Vinmec Central Park International General Hospital.

Falls in the elderly are a common and complex geriatric problem. Falls are the leading cause of injury and death in people over 65 years of age. Fall events cause disability, reduced mobility, and even death. Falls have many causes and are associated with risk factors.

Falling can be the first sign of an acute problem (infection, orthostatic hypotension, arrhythmia). Falls can result from a chronic illness (parkinsonian disease, dementia, diabetic neuropathy). Or falls could simply be a sign of the progression of “normal” age – changes related to vision, gait and muscle strength.
Furthermore, most falls experienced by the elderly are multifactorial and interactive (eg, tripping over obstacles due to gait disturbances and poor vision).
Falling and fear of falling are interrelated issues. Many older adults who experience falls, whether they are traumatized or not, develop a fear of falling, leading to reduced activity, impaired social interactions, depression, and increased risk of falls. than. The fear of falling, which causes reduced mobility, also leads to increased muscle stiffness, which is also the cause of falls.
Studies have identified 30 types of causes of falls. Commonly cited reasons for seniors' falls are loss of balance, weather, negligence, medical conditions, indoor or outdoor obstacles, dizziness, muscle weakness.

Besides, it is impossible not to mention the cause of falls due to drugs. There are many medications that can cause falls with low to high risk. Older people often have to take long-term medication because of many chronic diseases. 80% of elderly people use prescription drugs daily.
Balance disorders are an important risk factor for falls. In contrast, muscle weakness is an important modifiable risk factor. Leg strength is very important to maintain independent living for the elderly. Elderly people often suffer from osteoarthritis of the knee, hip, and muscle strength leading to changes in gait swaying, loss of balance and falls.

Accidental falls cause nearly 1.7 million injuries in older women each year. This results in a 56% higher injury rate in women than in men. For older adults living in the community, common activities reported for falls include walking (42-64% of falls), jogging or running (4-12%), turning around. (7%), get up from a chair (3-12%), go up (3-7%) or go down stairs (7-9%).
The majority of falls were related to movement (33%) or slips (22%). Most falls occur during waking hours.
It is notable to fall while turning, as more than half of such falls are backwards. This is the direction of the fall related to injury of the hip joint, pelvis. Nearly half of all falls injure the hip or pelvis, and more than one in five injure the wrist or hand. And it's not surprising that nearly all hip fractures (98%) are caused by falls.
Falling with an incline is more likely to impact the elbow. Therefore, when falling with an inclined direction, the patient has a reflex against the hand to reduce the level of impact on the hip and pelvic joints. But the opposite can cause fractures in the wrist, elbow and shoulder areas.

In summary, falls are the leading cause of fatal and non-fatal injuries in older adults. Even people who fall and are not injured often experience negative health consequences. Therefore, it is necessary to pay attention to the event of falls in order to take appropriate preventive measures.
Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, a system of modern equipment and technology. The hospital provides comprehensive and professional medical examination, consultation and treatment services, with a civilized, polite, safe and sterile medical examination and treatment space.