How to Prevent Falls Among Older Adults
How to Prevent Falls Among Older Adults
Vitamin D plays a central role in calcium and phosphorus hemostasis and skeletal health; its inadequacy is a largely unrecognized epidemic in many populations worldwide. Research shows vitamin D and calcium supplementation significantly reduce older adults' fall risk.
Counsel postmenopausal women on the benefits of regular exercise to help maintain muscle and bone strength throughout adulthood, reduce the risk of fragility, promote overall fitness, and improve quality of life. Regular weight-bearing exercise can preserve bone mass and conserve or improve bone mineral density; it also might reduce hip-fracture risk by decreasing the risk of falls.
Epidemiologic evidence suggests that being physically active can nearly halve the incidence of hip fracture in older adults—an effect probably mediated through the positive effects of exercise on bone, muscle strength, balance, and joint flexibility. Studies have found that women who engaged in a walking program and other leisure-time activities were 55% less likely than sedentary women to suffer a hip fracture. Also, aerobic, weight-bearing, strength-training, and stretching exercises increased lumbar-spine bone mineral density in women receiving calcium and vitamin D supplements. Although the average older woman isn't likely to exercise to the level needed to build bone, exercise is crucial to strengthening muscles, improving balance, and preventing falls. Ideally, a weekly exercise program should incorporate at least three sessions lasting 30 to 60 minutes each.
Research shows exercise and hormone replacement therapy (HRT) have independent benefits in early postmenopausal women with adequate calcium intake. In a 12-month study, 320 women (average age, 56) who were 3 to 11 years postmenopausal were prospectively randomized into two groups—those receiving HRT and those not receiving it. Both groups either participated in a supervised weight-bearing and weight-lifting program or continued their current physical activity level. All the women received calcium citrate 800 mg/day. After 12 months, those who'd exercised experienced significant mean increases in trochanter bone mineral density. Those who'd received HRT showed significantly increased bone marrow density in the total body and at the lumbar spine, regardless of exercise status. Women who'd neither exercised nor received HRT generally lost bone mineral density at all sites.
When encouraging older adults to increase their activity level, consider their possible need for pain management. Older adults frequently complain of joint pain. If acetaminophen or nonsteroidal anti-inflammatory drugs fail to bring relief or if a patient has more than mild or moderate pain, consider opioids. Keep in mind that older adults generally achieve pain relief from smaller opioid dosages than younger people.
Poor Nutrition and Limited Activity
Vitamin D plays a central role in calcium and phosphorus hemostasis and skeletal health; its inadequacy is a largely unrecognized epidemic in many populations worldwide. Research shows vitamin D and calcium supplementation significantly reduce older adults' fall risk.
Counsel postmenopausal women on the benefits of regular exercise to help maintain muscle and bone strength throughout adulthood, reduce the risk of fragility, promote overall fitness, and improve quality of life. Regular weight-bearing exercise can preserve bone mass and conserve or improve bone mineral density; it also might reduce hip-fracture risk by decreasing the risk of falls.
Epidemiologic evidence suggests that being physically active can nearly halve the incidence of hip fracture in older adults—an effect probably mediated through the positive effects of exercise on bone, muscle strength, balance, and joint flexibility. Studies have found that women who engaged in a walking program and other leisure-time activities were 55% less likely than sedentary women to suffer a hip fracture. Also, aerobic, weight-bearing, strength-training, and stretching exercises increased lumbar-spine bone mineral density in women receiving calcium and vitamin D supplements. Although the average older woman isn't likely to exercise to the level needed to build bone, exercise is crucial to strengthening muscles, improving balance, and preventing falls. Ideally, a weekly exercise program should incorporate at least three sessions lasting 30 to 60 minutes each.
Research shows exercise and hormone replacement therapy (HRT) have independent benefits in early postmenopausal women with adequate calcium intake. In a 12-month study, 320 women (average age, 56) who were 3 to 11 years postmenopausal were prospectively randomized into two groups—those receiving HRT and those not receiving it. Both groups either participated in a supervised weight-bearing and weight-lifting program or continued their current physical activity level. All the women received calcium citrate 800 mg/day. After 12 months, those who'd exercised experienced significant mean increases in trochanter bone mineral density. Those who'd received HRT showed significantly increased bone marrow density in the total body and at the lumbar spine, regardless of exercise status. Women who'd neither exercised nor received HRT generally lost bone mineral density at all sites.
When encouraging older adults to increase their activity level, consider their possible need for pain management. Older adults frequently complain of joint pain. If acetaminophen or nonsteroidal anti-inflammatory drugs fail to bring relief or if a patient has more than mild or moderate pain, consider opioids. Keep in mind that older adults generally achieve pain relief from smaller opioid dosages than younger people.
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