Neurology Insights

More Than “Just a Fall”: A Look into Accident Proneness and Aging

Photo of a man falling down and a young woman helping him uo

“Grandpa just slipped and fell again…” 

“…why do I keep tripping over my rug?”

If you are a senior or have senior loved ones, you may be familiar with the all-too-common mobility changes associated with aging. You may notice Grandpa, although an active golfer, has become increasingly clumsy lately, or you may find yourself tripping over frequented areas in your home as time passes.

Although it appears that aging and clumsiness go hand in hand, the truth is that falling and accidents are not an inevitable part of the aging process and can often be prevented.

Today, one in four older adults experiences a fall every year, with falls being the leading cause of injury-related death among adults ages 65 and over.

With such devastating effects, it is important to understand why falls happen, the warning signs, and what we can do to prevent them. Awareness of the dangers of falling can prevent injury and disability and give you more years of higher-quality living.

Understanding Falls

Why do falls happen?

Most people tend to think of a trip or a fall as a casual misstep with little to no further investigation needed. And, for most individuals under 65, this is likely true. However, for older adults, a fall or two within a year is enough to raise concerns regarding neurological and physical health.

As we age, changes in the vestibular system (the inner sensor located in the ear canal that senses balance) and the cerebellum (part of the brain that controls fine motor skills) take place. Small changes, such as a decrease in sensory hair cells and reduced fluid in the inner ear, are enough to impact the brain’s ability to communicate effectively with the muscles and reflexes that help a person stay balanced.

Older adults have already begun to see a decrease in the size of the cerebellum, also known as “the motor” (or balance center), in the back of the brain around the age of 50, thereby significantly changing how the brain processes mobility.

The Most Common Causes of Falls

Are all falls a result of simply “getting old”? Not quite. In many cases, a fall can be the cumulative result of aging, as well as an underlying neurological disease, medical condition, or more.

Understanding these factors and making lifestyle changes to accommodate for them can be the difference between having a painful fall or a fall at all.

Age-Related Changes

With aging comes inevitable wear and tear, and depending on an individual’s lifestyle, this can contribute to accelerated muscle weakness, reduced bone density, and slower reflexes. All of these factors can make an individual more accident-prone.

Medical Conditions

Because the brain and the body are so deeply integrated, patients with an underlying neurological condition can be at increased risk of experiencing a fall.

  • In Parkinson’s, Multiple Sclerosis, and Diabetic Neuropathy, difficulty with balance and dizzy spells lead to an increased likelihood of experiencing a fall.
  • Experiencing a stroke or transient ischemic attack increases a person’s risk of falling during and after an attack.
  • Vision and hearing loss due to aging or injury can also impact the body’s ability to sense the environment, leading to falls.
  • High blood pressure and poor circulation can also impact the body’s agility, leading to increased proneness to accidents.
  • As we age we are much more sensitive to dehydration, and this can lead to near syncope and lightheadedness, which can contribute to falling.

Medication Side Effects

Many common medications have side effects that mimic the challenges that lead to falls, including dizziness, drowsiness and low blood pressure. It is critical to use extra caution when taking any medications and communicate all of your medications to your doctors to avoid any dangerous, unintended combinations.

Environmental Factors

A large percentage of falls come from environmental factors. Poor lighting, uneven or slippery floors, and clutter can quickly become hazards when combined with medical conditions and other variables.

The Hidden Risks of Ignoring Falls

Often, we think of falls as accidents – which they are – however, in many cases, falls can also serve as a warning sign not to be ignored.

Feeling dizzy? Speak up! Feeling clumsy? Seek advice.

One of the most important things you can do to prevent serious injury by falls is to speak up when you feel any minor symptoms or have an initial fall. While it can feel embarrassing, or you may not want to believe what happened, a simple checkup can help prevent further damage. A medical professional can help to put your mind at ease and give you the knowledge to make good decisions moving forward.

Oftentimes, patients express that they have bouts of dizziness or trouble balancing, but rarely do they realize that this may be a sign of an underlying condition that can contribute to a fall injury down the line. In many cases, dizziness is a symptom of an underlying condition like Parkinson’s disease or stroke or directly related to other issues like inner ear problems, muscle weakness, heart disease, and general aging.

When a fall happens, you can feel confused and caught off guard. Beyond the physical challenges, falls often take a significant emotional and financial toll. Catching the cause of a fall early can help prevent recurrent falls, a leading cause of hospitalization, broken bones, TBIs, and a decreased quality of life.

Proactive Steps to Prevent Falls

While we may not have control over the progression of a medical condition or the aging process, we can foster a lifestyle and environment that decreases the chances of falls and accidents.

Lifestyle Adjustments

Exercise

Not surprisingly, exercise can help improve coordination. For those with a low risk of falling, exercises can help build back the strength to stand without support. A physical therapist can walk you through techniques suitable to your ability.

Exercise not only helps build strength, but it can also promote increased cognitive function, increasing your ability to stay alert and react quickly. Starting with chair aerobics, and then including activities, such as walking in the water or even yoga/tai chi/Pilates can be extremely effective.

Diet

Incorporating calcium, vitamin D, protein, and proper hydration can improve bone and muscle strength. Proper diet and supplements all work together to decrease the chance of falls as well as reduced the risk of injury if you do fall.

Reduce Fall Hazards

A majority of falls happen at home, with 80% of those occurring in the bathroom.

Our physical abilities change as we age, but our environments often stay the same! Maybe when you moved into your home, you loved having an upstairs bedroom, but now it has become a challenge. Fortunately, there are many low or no-cost ways to improve the safety of your home.

Check out Dr. Kandel’s checklist here

 

Health Checkups

Staying ahead of any health challenges will pay dividends. Making sure to schedule regular eye and ear exams can help identify any potential issues that could impact balance or cause dizziness before they happen.

Always review your medications with your healthcare providers. Many drugs or drug combinations can lead to dizziness and low blood pressure. Don’t assume that your physician or medical provider knows every drug you are prescribed, and if you ever feel any side effects, make sure to let them know right away.

A Message From Dr. Kandel

“As I tell all of my patients, you are not a Runco oven and we do not set it and forget it. We need to be constantly monitoring your symptoms and your medications. Oftentimes, a blood pressure medicine that was effective in the past may no longer be necessary and may be leading to low blood pressure. Diet, nutrition, and exercise are always the cornerstone of a healthy lifestyle. With the start of the new year, making a commitment to a healthier lifestyle is much easier than you may think. Doing 30 minutes of chair aerobics a day, increasing your water intake, or even joining that yoga class that you’ve been meaning to do can be very helpful in improving your health and reducing your risk of falls and other injuries. Let’s make a commitment to a new, healthier you!”

Dr. Joseph Kandel portrait

Joseph Kandel, MD

Board Certified Neurologist
Serving Naples and Fort Myers, FL

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