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Dementia: A Major Cause of Falls
I n a recent New York Times article, Steve Lohr wrote “Falls are so harmful to the elderly
and so costly to society, that if falls were a disease, they would be deemed an epidemic*.”
And According to Marlo Sollito: “Falls are the leading cause of death, injury and hospital
admissions among the elderly population.”
Though falls among the elderly are often a result of some other health problem such as
cardiovascular weakness, or something as seemingly simple as dehydration, far and away the
greatest risk of falls is dementia. A person with dementia (PWD) is 3 times more likely to fall
than are others of the same age. This is due in part to the difficulties a PWD experiences in
seeing (e.g., problems with spatial relationships and depth perception), in thinking (e.g., confusion,
misperceptions), in balancing (e.g., diminished reaction time), and in moving (e.g. inability to
perform purposeful acts such as walking — known as apraxia).
Although we may not be able to completely prevent falls we can reduce the risks of falling
and ameliorate some of the trauma associated with a fall. Research into the problem of falls
suggests that the way to accomplish this consists of a combination of:
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Medication review: Sedatives, anti-psychotic drugs and taking multiple medications are
implicated in heightening the risk of falls.
- Exercise: Exercise programs which are tailored to individual differences and interests, are
ongoing, target balance and strength have an impact on fall reduction.
- Environmental modifications: Simplify the environment. Too much clutter can be distracting
and add to the PWDs confusion. Ensure proper lighting. Install falls prevention
products such as grab bars and shower chairs in bathrooms. The entire spectrum of environmental
modifications has many components and is best approached by a careful review
of each room to identify potential needs. For guidance through this review process go to
www.thiscaringhome.org.
- Early intervention: Something as simple as wearing properly-fitted low-heeled shoes adds
to balance and stability. Develop care plans based on individual assessment of the PWD’s abilities
and needs with particular attention to causes of falls. This is perhaps the most effective
way of preventing them.
The science and industry surrounding fall prevention has captured the interest of researchers
in the fields of aging and technology. We can anticipate that this will lead to more accurate and
early assessment of risk along with intervention strategies.
— Della Frazier-Rios, RN, MS
Senior Vice President,
Director of Education
& Outreach
* The estimated cost of falls ranges widely, up to $75 billion a year in the United States, if fall–related
home care and assisted-living costs are added to medical expenses.
Two additional good resources for information about falls are:
http://www.temple.edu/older_adult/ — on this
site you will find an “In-Home Safety Check” and
tips on home safety.
http://www.stopfalls.org/researchers_educators/re_fr.shtml— on this site you will find
amongst other information, a sizeable bibliography on falls and falls-prevention articles.
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