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What Causes Falls?

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“A fall” is a familiar cause of injuries suffered by the elderly—but what caused the fall?

November 22, 2013


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watch your step

“A fall” is a familiar cause of injuries suffered by the elderly—but what caused the fall? Don’t just assume it comes with age, warns Sarasota occupational therapist Sally Thimm. “It’s not unusual to have patients in their 80s and 90s be independent, live alone and continue to drive safely,” she says. “There is always a reason that a person falls.”

It’s important to treat not just the fall itself, but the underlying cause, which may be (or lead to) an even more serious condition.

“In a perfect world, our muscles support our bones in harmony when we’re standing and adjust when we take on different postures—walking, moving forward to stand from a chair, getting out of bed, getting on and off the toilet, and so on,” she says.

Thimm cites six reasons falls occur, all of which call for a doctor’s follow-up to explore treatment options:

•    Vision: “Limitations in vision can impact accuracy of steps, determination of curb or threshold heights and can affect depth perception,” she says.

•    Joint pain: “If someone is having arthritic pain in a hip, knee or ankle, they  may be unconsciously or consciously shifting their weight to the side that is strongest to reduce pain,” says Thimm. “This causes a problem with balance and can also cause damage to the ‘good side,’ due to overuse and inflammation.”

•    Coordination: Changes in coordination, especially gait and posture, affect balance. “When a person shuffles when they walk, or stops picking up their feet, that could be a sign of a change in their neurological status,” says Thimm.

•    Blood pressure: We’re always on the lookout for high blood pressure, but low blood pressure can cause dizziness and weakness in the legs. Thimm says to check the blood pressure while sitting, then stand and wait three to five minutes before checking the standing blood pressure; checking it immediately after standing won’t be accurate.

•    Changes in metabolism/endocrine system: Diabetes or physiological conditions that affect blood sugar can lead to lightheadedness. “You need to be following your physician’s orders to maximize internal stability,” says Thimm.

•    Benign paroxysmal positional vertigo (BPPV): “This condition is characterized by intense sensations of dizziness or of a feeling that the inside of your head is spinning,” says Thimm. Your physician can recommend exercises that are often very successful in treating the condition.

For what it’s worth, when it comes to balance, my mother, who’s in her late 60s, cannot stop singing the praises of yoga. Balance can suffer simply because you’ve lost range of motion and strength as you’ve gotten older. Yoga asks you to develop stability—in part by strengthening both large and smaller, underutilized muscle groups—in a full range of motion.

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