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‘Can be completely life-altering': OHSU doctors talk prevention amid increasing rates of falls among older adults

OHSU has seen a sharp increase in ground-level falls over the past five years. For older adults, these falls can be life-changing or even deadly.

PORTLAND, Ore. — Dangerous falls among older adults are on the rise. It is one of the biggest causes of traumatic injuries treated and Oregon Health & Science University.  It usually involves people toppling over on level ground.

These falls, known as ground-level falls, can be life-altering or deadly, experts like OHSU Geriatrician Dr. Katie Drago say many of these falls are preventable.

“More people aging well. That’s wonderful. That means medicine has worked, but it means more people are living longer with chronic illness, with lots of medications and sometimes falls can be the canary in the coal mine,” she said.

A fall is often the result of new medication or combination of medications that has gone wrong. It could also mean there is a new diagnosis or even an existing diagnosis that should be looked into.

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Ground-level falls made up about 19% of all patients treated for trauma at OHSU in 2021. The hospital has seen a sharp increase in these types of falls over the past five years.

OHSU is one of two Level 1 trauma centers in Oregon that has treated a total of 756 people for ground-level falls in calendar year 2021. A sharp increase over the 486 such injuries treated in 2017. More than 75% of those cases involved people older than 65.

While it might not seem as dangerous as other traumas; think gunshots, stabbings, car crashes – it is the second leading cause of unintentional injury deaths worldwide, according to the World Health Organization.

Falls are the number one cause of accidental injury in older adults in the U.S. That’s everything from hip, event traumatic brain injury, shoulder and spine fractures to blunt injury to the chest.

“A lot of these can be completely life-altering events where, even if patients survive, their life may never be the same,” Drago said. “The ability to live independently, to do certain things, engage in certain hobbies, live in the community might be forever changed as the result of an injury.”  

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We all have someone in our lives -- a grandparent, parent, neighbor or friend – who may be at risk of falling and having it dramatically change their lives. Dr. Drago says there are things we can do to help each other.

“It’s really important because falls are preventable. There’s always something we can do to help reduce the risk or reduce the risk of injury from a fall,” she said.  

First, be mindful of your medications. While falls aren’t typically due to any one thing, it could be a combination of factors. Medications combined in unanticipated ways can lead to dizziness and falls.

“There are a lot of medications out there that can do wonderful things for people, but have side effects like dizziness, changes in blood pressure, confusion or fatigue and even making walking a little more difficult,” Drago said. “And often there are things we can do; like adjust doses or change medication that may be a little more tolerable without those same side effects.”

It’s also worth discussing whether bifocals used for reading may not be ideal for moving around.

Next. proper exercise. Drago says daily physical activity is key including aerobic exercise, strength training and balance exercises like tai chi.

“Working on balance and doing balance training, which we can all do in our 30s and 40s as well to improve balance can really pay benefits,” Drago said.

The Chinese practice of Tai Chi has shown medical evidence to reduce, not just the risk of falling, but also reduce the risk of injury from falling, according to Drago.

Finally, clear a path. This can be everything from reducing clutter around the house and in hallways to having adaptive equipment installed.

“Being critical appraisers of our own environment can actually anticipate problems before they become problems and then using experts at our disposal like occupational therapists, which really are the McGivers of medicine to come into the home through services like home health,” Drago said.

Sometimes minor adaptions often covered by insurance can help seniors live better and more independently with a safer risk of falling.

It’s all about taking charge of your health and looking for the people in your life. Drago says to talk to your doctor about any concerns and to go in after a fall.

All of these steps can help older adults minimize the risk of falling and to continue to live independently.

“Falls can be prevented. It’s not an inevitability, it’s not a normal part of ageing and there’s lot of us in the healthcare community that are here to help reduce the risk of falling, keep you healthy, keep you independent and keep you an active part of your life,” Drago said.

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