We All Fall Down

In the spirit of Independence Day, be aware of another  threat to our freedom. There is a silent epidemic that is causing injury, disability and possibly death. It is insidious and affects all of us if we’re not careful. It is a force called gravity and of course without it we’d all float away. In older adults, it grabs us when we’re careless and results in falls that lead to injuries and potential loss of our independence. Unfortunately, a growing part of our population develops problems with maintaining a sufficient level of fitness that keeps them grounded, so to speak.  Estimates are that  30 percent of folks 65 and older report they can’t walk three blocks or climb a flight of stairs.

Certainly those adults with neurological disorders or orthopedic problems are at obvious risk of falls. Usually they’re not hard to spot—shuffling gait, bent posture, difficulty breathing when walking. We can find multiple reasons in three-quarters of older patients for why they have a gait or balance problem. A medical evaluation is paramount; especially one that looks hard at any medications (as in, “do we really need that medication?”) associated with the risk of falls. A favorite test is the timed “Get Up and Go” test. It’s power is in its simplicity at identifying those at risk of falls. In medicine, we say it is sensitive in picking up those folks at risk and specific that those folks really are at risk. Patients having difficulty passing this test are at high risk for fall and need further evaluation pronto.

The good news is that we can reduce falls by up to 40 percent if we intervene timely. One critical component is exercise. Those patients participating in exercise programs, especially supervised groups, significantly reduce their subsequent risk of falls. One popular form of exercise, performed by all ages, called tai chi helps with strength and flexibility. We can achieve muscle strength with light weights and little effort, improving our balance and endurance. Our physical therapist friends can also help by providing individualized plans to overcome any limitations. Incorporating exercise into our daily routines now can help prevent future disabilities and allow us to stay as independent as our forefathers intended.

Now that’s something to celebrate.

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About Steve P. Sanders

A general internist writing and sharing ideas and art.

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