The Fall In The Elderly
Falling in the elderly is a major public problem in terms of its medical and economic consequences. In addition to the fall, the highest mortality and disability are seen in the elderly group. One third of the population over 75 years of age falls at least once a year.
Causes of falling
Falls can occur due to aging-related problems or inappropriate environmental conditions. In general, falls occur after syncope (loss of consciousness), cerebrovascular event (blockage or bleeding in the brain vessels) or a seizure.
1. Physiological changes in the elderly
- Vision problems: Decreased visual acuity, decrease in darkness, glare
- Reduction in contrast sensitivity
- Hearing balance problems, speech and balance deterioration
- Nervous system problems, slowdown in reaction time, deterioration in sense of position, deterioration in posture, emergence of elderly gait
2. Falling health problems and drugs in the elderly
Diseases of the nervous system: Cerebrovascular diseases, Parkinson’s disease, spinal cord diseases, seizures, cerebellum diseases, neuropathy diseases of the arm and leg, dementia, delirium
Diseases of the cardiovascular system: heart attack, hypotension, blood pressure, arrhythmia
Diseases of the gastrointestinal tract: bleeding, diarrhea, due to discharging problems, fainting, excessive post-fainting
Endocrine system problems: Less work of the thyroid gland, drop of blood sugar, anemia, potassium deficiency, loss of fluid in the body, sodium deficiency
Diseases related to the urinary system: Urinary incontinence, frequent urination at night
Musculoskeletal diseases: Arthritis, weakness in muscles
Psychological diseases: Depression, increased anxiety level (anxiety), panic attack
Medicines: Walking with aging also changes. The elderly male adopts the wide-stride type and the old woman adopts the narrow type of gait, defined as waddle or body. More than 15% of the elderly have significant gait disturbance and more than 25% need an assistive device such as walking stick and walker. In addition, environmental factors such as slippery floors, inappropriate lighting and no handrails are responsible for 33% to 50% of falls. In-house falls are mostly in the bathroom, in the bedroom and in the kitchen, and out-of-house falls are mostly on steps and curbs.
Falls in the elderly often have more than one cause, and 70% result in injury. The most common problem is hip and forearm fractures.
Complications due to falls:
- Injuries: Painful soft tissue injuries, fractures of the hip, limb, arm, wrist and ribs, bleeding under the brain membrane
- There is a need for hospitalization and long-term complications (bed sores, lung infections, etc.) arise.
- Disability (Loss of movement due to physical injury, loss of movement due to fear and insecurity)
- Death
Basic principles of protection
Detection, elimination or rehabilitation of the problem that causes falls, as well as the provision of environmental regulations to reduce the risk of falls and the severity of injuries caused by falls. Impairments in auditory and visual perception, co-ordination and balance, associated with aging; it makes it easier for elderly people to face environmental hazards, In this context, attention should be paid to home security and necessary adjustments should be made in the house. It will be possible to prevent accidents in the home by means of conscious but simple measures.
Source: The official website of Geriatrics Society.