Additionally, some older adults may be on multiple medications for high blood pressure, which can worsen postural hypotension. Dehydration, which is also common among the elderly, can further exacerbate this problem. Ensuring proper hydration and a review of medications are essential to manage this risk.

Q: Are there other common medical conditions that contribute to falls?

Dr. Pelpola: Yes, another frequent cause of falls in the elderly is Benign Paroxysmal Positional Vertigo (BPPV), BPPV IS a type of vertigo caused by changes in the inner ear, where small particles move out of place, causing dizziness when the head is repositioned. This condition often leads to falls, particularly when a person moves their head suddenly. Treatment for BPPV typically involves maneuvers performed by an ENT specialist to reposition the particles in the ear, but it is not suitable for everyone, particularly those with neck problems. In some cases, medications may also be required.

Q: What role does vision play in fall prevention?

Dr. Pelpola: Vision is another critical factor in fall prevention. Many older adults suffer from uncorrected vision problems, often continuing to use glasses that may be outdated or inefficient. Poor vision can make it difficult to navigate safely and can significantly increase the risk of falls. It's essential for elderly individuals to have regular eye tests and to update their prescriptions as needed. Additionally, vision problems such as cataracts or macular degeneration, which are common in older adults, can also impair balance and increase falls risk.

Q: You mentioned heart problems earlier. Can you elaborate on how these contribute to falls?

Dr. Pelpola: Absolutely. Some heart conditions can lead to dizziness, fainting and falls. For instance, aortic stenosis occurs when the aortic valve becomes narrowed, restricting blood flow and causing symptoms like dizziness, chest pain, and fainting  People with heart rhythm issues (arrhythmias), can experience sudden drops or increases in heart rate, which can cause dizziness and increase the risk of a fall

It's crucial for anyone who experiences blackouts or fainting episodes, even if it's not accompanied by fails, to seek immediate medical attention. These could be signs of underlying heart or other systemic issues that require investigation

Q: What are the potential consequences of falls in older adults?

Dr. Pelpola: The consequences of falls can be severe, particularly for older individuals, One of the mast significant risks is head injury, Older adults are more likely to be on blood-thinning medications, which increase the chances of bleeding in the brain, even from minor falls. This can lead to brain Injury, paralysis, or even death if not treated promptly.

Fractures are another major concern. Hip fractures, wrist fractures (often from trying to break a fall), and spinal fractures are common in the elderly and can lead to long-term disability, immobility, and a decline in quality of life Osteoporosis, a condition where banes become weak and brittle, is particularly prevalent among older adults and increases the risk of fractures.

Apart from physical injuries, falls can lead to a loss of confidence. Many older adults become fearful of falling again, leading to a decline in their mobility. This creates a vicious cycle where they become more sedentary, lose muscle bulk and strength (a condition known as sarcopenia) and further increase their risk of falling.

Q: How can Geriatric Medicine help reduce the risk of falls?

Dr. Pelpola: Geriatric Medicine plays a critical role in identifying and managing the various risk factors associated with falls. A Comprehensive Geriatric Assessment looks at multiple aspects of an older adult's health, including mobility, medications, and overall physical and mental well-being. Here's how it can help:

1. Medication Review: Older adults often take multiple medications, some of which may. Increase the risk of falls. A Geriatrician can review all 4 medications to see if any of them are contributing to dizziness, low blood pressure, or balance. issues. For example, reducing the number of blood pressure. medications or adjusting doses can help prevent postural hypotension

2. Physical Therapy: Physical therapy is a cornerstone of fall prevention. A tailored exercise program focusing on strength, balance, and coordination can significantly reduce the risk of falls, Geriatricians can work with physiotherapists to develop a program suited to the individual's needs and abilities.

3. Assessment for Osteoporosis:

Osteoporosis increases fracture risk, and early diagnosis can help prevent serious injuries, Geriatricians often assess for osteoporosis and can recommend treatment options, such as calcium and vitamin D supplements, as well as more soecific medication such as Alendeonic Acid. This helps to strengthen bones and reduce fracture risk.

4. Vision and Hearing: Regular screening for vision and hearing problems is important.. Geriatricians can refer patients to eye doctors or audiologists for further evaluation. Ensuring proper corrective eyewear or hearing aids can significantly improve. Safety and mobility.

5. Environmental Modifications:

After assessing for falls risk, Geriatrician may recommend changes to the home environment, such as improving lighting, reducing tripping hazards, and installing grab bars in bathrooms. These modifications can make a significant difference in preventing falls, especially at night.

Q: What can families and caregivers do to support fall prevention at home?

Dr. Pelpola: Families play a crucial role in fall prevention, First and foremost, it's important to maintain the individual's Independence. While it's natural to want to protect loved ones, we should avoid becoming overly protective, as this can lead to a loss of confidence and increased isolation. Instead, encourage them to remain active, but provide supervision where necessary.

Some practical steps families can take include:

Encouraging Hydration: Older adults may forget to drink water, so placing water bottles around the home can serve as a reminder.

Safety Modifications: Install handrails, remove clutter, and ensure that areas like hallways and bathrooms are well-lit and free of obstacles.

Supporting Physical Activity: Encourage the elderly person to engage In physical activity, such as walking or light stretching, to maintain muscle strength and balance.

Regular Check-ups: Regular medical check-ups are essential Geriatricians can help identify issues like vitamin D deficiency, which can affect muscle strength, and recommend treatment.

Q: In conclusion, what's the key message for preventing falls in older adults?

Dr. Pelpola: The key is prevention through a holistic approach. Falls are not just a result of aging: they are often the outcome of multiple factors, including medical conditions, side effects of medications, environmental hazards, and lifestyle factors. A Geriatrician can assess all these aspects and develop a personalized plan to reduce the risk of falls. By focusing on improving mobility, strength, vision, and managing underlying health conditions, we can significantly reduce the risk of falls and enhance the quality of life for older adults.

The goal is always to keep older adults. as independent and healthy as possible, and with the right care, falls can be minimized. It's Important for families and caregivers to support this effort by creating a safe environment and encouraging active lifestyles. Preventing falls is not just about addressing immediate risks but fostering long-term health and safety. - Naleef Kitchil