Factors associated with an increased risk of falling among older adults

I make fun from time to time of the commercial on TV that talks about the dangers of getting seniors up and downstairs. The solution they say, “is just don’t fall.” That is easier said than done according to Seniors’ Falls in Canada, SECOND Report published in 2014 by Health Canada. In this report, they examine in a lot of detail why seniors fall, and the costs associated with when senior’s fall, on our society Here is some of what they have to say

Most falls occur as a result of compounding factors that combine and overwhelm an older person’s ability to maintain or regain his or her balance. These factors typically represent a complex interaction of biological, behavioural, environmental and socio-economic conditions termed “risk factors”. Research has identified numerous conditions that differentiate between older persons who fall and those who do not fall. Each older person may face a unique combination of risk factors based on life circumstances, health status, health behaviours, economic situation, social supports and the environment. Understanding what puts a person at risk of falling is a critical step in reducing falls and fall-related injuries among older Canadians.

The broad set of conditions that have been demonstrated to increase the risk of falling among older persons can be categorized as biological/ intrinsic, behavioural, environmental and social/ economic. These risk factors do not exist in isolation but are instead complex and interactive.

The order in which the following risk categories are presented is not based on their relative importance but, instead, in accordance with their presentation in Scott, Dukeshire, et al., and then specific factors are addressed alphabetically.

Appendix B

 Biological/ Intrinsic

• Impaired mobility

• Balance deficit

• Gait deficit

• Muscle weakness

• Advanced age

• Chronic illness/disability:

• Cognitive impairment

• Stroke

• Parkinson’s disease

• Diabetes

• Arthritis

• Heart disease

• Incontinence

• Foot disorders

• Visual impairment

Behavioural

•      History of falls

•      Fear of falling

•      Multiple medications

•      Use of:

•      Antipsychotics

•      Sedative/hypnotics

•      Antidepressants

•      Excessive alcohol

•      Risk-taking behaviours

•      Lack of exercise

•      Inappropriate footwear/clothing

•      Inappropriate assistive devices use

•      Poor nutrition or hydration

•      Lack of sleep

Social & Economic

•      Low income

•      Lower level of education

•      Illiteracy/language barriers

•      Poor living conditions

•      Living alone

•      Lack of support networks and social interaction

•      Lack of transportation

•      Cultural/ethnicity

Environmental

•      Poor building design and/or maintenance

•      Inadequate building codes

•      Stairs

•      Home hazards

•      Lack of:

§  Handrails

§  Curb ramps

§  Rest areas

§  Grab bars

§  Good lighting or sharp contrasts

•      Slippery or uneven surfaces

•      Obstacles and tripping hazards