Decreasing Fall Risk in the Elderly

Falls pose a serious threat to those attempting to stay out of the hospital and maintain their independence, particularly the elderly. Falls can lead to additional cost of care, extended inpatient stays, increased risk of future falls, and even death.

To help address this issue, researchers have been looking to pinpoint solutions to lower the frequency of serious fall injuries both in and out of care facilities. One of those is exercise, which has been shown to lower instances of falls in seniors. Vitamin D level, once thought to also aid in reducing falls, has actually been shown to have the opposite effect.

Exercise Programs

A new study suggests that older men who moderately exercise several times a week are at a reduced risk of a serious fall injury and broken bones. Although exercise was not shown to reduce the number of fall injuries, among men it did help to lessen the seriousness of those injuries. This is meaningful when looking at length of hospital stays and quality of life after a fall.

Exercise helps to increase mobility in both men and women, and exercises that focus on balance, gait and strength are the most beneficial.

Vitamin D

Originally thought to decrease the frequency of falls, increasing one’s vitamin D level has recently been shown to increase the number of falls.  A double-blind, randomized clinical trial with 200 community-dwelling men and women over 70 years old who had reported a previous fall concluded that those receiving 60,000 IU of oral vitamin D3 once monthly or 24,000 IU of oral vitamin D3 and 300 mcg of calcifediol once monthly were significantly more likely to fall than those receiving 24,000 IU of oral vitamin D3 once monthly.

For pharmacists hoping to understand why certain patients continue to experience high fall risk, testing vitamin D levels to see if they are elevated may shed some light onto the patient’s condition.

Implications

Falls are prevalent among the elderly, with nearly one-third experiencing a fall each year and 20%-30% of those falls lead to serious injury. Hip fractures can be especially debilitating. At least 50% of elderly people who were ambulatory before a hip fracture never fully recover. In the U.S., falls are the leading cause of accidental death in people age 65 and over.

The cost of treating falls in the elderly is also significant. By 2020, medical costs for falls are projected to reach $44 million.

By understanding and addressing the causes of falls, those in hospitals and nursing homes can save millions of dollars and maintain a better quality-of-life for their patients.

Related Articles:

Pharmacy Times

Reuters

Transform Healthcare

Merck Manual

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