March 17, 2023 — When Senate Minority Leader Mitch McConnell (R-KY) recently collapsed at a dinner event in Washington, D.C., he unfortunately joined a large group of his senior citizen peers.
It’s not the first time it’s fallen in the 81-year-old. In 2019, he had a fall in his home, breaking his shoulder. This time, he was hurt and was recently released to an inpatient rehabilitation facility. While McConnell did not fracture his skull, in falling and hitting his head, McConnell became part of an emerging statistic: one that suggests falls are more dangerous for senior men than for senior women.
This new research, which appeared in american journal of emergency medicineThat came as a surprise to lead researcher Scott Alter, MD, associate professor of emergency medicine at Florida Atlantic University College of Medicine.
“We always hear about lower bone density rates among women, so we didn’t expect to see men with more skull fractures,” he said.
Alter said that as a physician at a southern Florida facility, his ER department was the perfect study base for evaluating geriatric patients who came in because of falls. Older “patients are at higher risk of skull fractures and intercranial hemorrhage, and we wanted to see any patient with a head injury. However, some 80% were fall-related.
Statistics confirm the fact that falls of all types are incredibly common among the elderly: approximately 800,000 seniors are hospitalized due to falls each year.
Statistics show that the death rate from falls is increasing among senior citizen age groups as well, up to 30% from 2007 to 2016. 70% of sudden death in people 75 and older. They are also the leading cause of injury-related visits to emergency departments in the country.
Jennifer Stevens, MD, gerontologist and executive director at AB Delray South, Florida, is aware of the grim numbers and regularly looks at their results. “There are many reasons seniors are at risk of falling,” she said. “These include balance issues, decreased strength, diseases such as Parkinson’s and Alzheimer’s, side effects of their medications, and more.”
In addition, many seniors live in spaces that are not necessarily equipped for their limitations, and hazards exist in their homes. Put together, and the risk of falling is everywhere. But there are steps seniors, their families and even middle-aged people can take to reduce and hopefully stop a dangerous decline.
quick stare
While in many cases the journey to reducing fall risk begins after a fall, the time to address this issue is long before you complete your senior years. Mary Therese Cole, MD, a physical therapist and certified dementia practitioner at Manual Age Physical Therapy in Colorado Springs, CO, says age 50 is a good time to start meditating and reversing physical decline.
“This is an age where your vision can start to deteriorate,” she said. “It’s a big reason elderly people stumble and fall.”
Additionally, as our brains begin to age in our middle years, the neural pathways from the brain to the extremities begin to shrink as well. The result is that many people stop lifting their feet as much as before, which increases their chances of slipping.
“You’re not an old man yet, but you’re not a spring chicken either,” said Cole. “Whatever issues you have now will only get worse if you’re not working on them.”
A good starting point in middle age is to work on both strength training and balance exercises. A certified personal trainer or physical therapist can help you get on a program to overcome many of these falls.
If you’ve reached your later years, and are experiencing physical decline, it’s smart to check in with your primary care physician for an evaluation. “He may start you on regular PT to evaluate any deficiencies and then address them,” Cole said.
Cole said that when she is working with a senior patient, she will test their strength in getting up and down from a chair, do a manual strength test to check the lower extremities, check their range of motion, and ask about conditions such as diabetes, prior surgeries. and other conditions.
From there, Cole said she could prescribe a plan for the patient. Similarly, Stevens uses a program called Be Active that allows her to test seniors on a variety of measurements, including flexibility, balance, arm strength and more.
“Then we match them with classes to address their deficiencies,” she said. “It is important that seniors do not have the ability to recover and fall if their balance is impaired.”
In addition to working at your physical limits, taking a good look at your home is also essential. “You can have an occupational therapist come to your home and do an evaluation,” Stevens said. “They can help you rearrange and reorganize for a safer environment.”
Large, common household fall hazards include throw rugs, lack of nightlights for middle-of-the-night trips to the bathroom, lack of grab bars in the shower/bathtub, and furniture blocking the way.
For his part, Alter prefers to point the seniors and their doctors to the C.D.C. Stable program, which aims to prevent elderly accidents, deaths and injuries.
“This includes screening for fall risk, assessing factors you can modify or improve, and more tools,” he said.
Alter also recommended that seniors talk to their doctor about medications, especially blood thinners.
“At a certain point, you have to weigh the benefits of disease prevention with the risk of injury if you fall,” he said. “The risk of bleeding can be very high if the patient is at high risk of falling.”
