Introduction

The major strategies to prevent falls in the elderly are reducing the risk-factors leading to falls. Most falls among older persons are associated with identifiable and modifiable risk-factors. It is also known that risk is greatly increased for those with multiple risk-factors.

Promoting Healthy lifestyle – Healthy ageing

Elderly are encouraged to practice healthy lifestyle to boost their health. This can be achieved through adopting and adapting healthy lifestyles such as healthy diet, don’t smoke, no or moderate alcohol consumption, maintaining weight and exercising. This can also prevent them from getting chronic disease complications which will directly and indirectly put them at high risk to fall.

Reducing Risk-Factors for falls

There are many risk-factors for falls but basically they can be divided into internal factors (i.e: those related to the patients’ health and external factors (i.e: the environment they are in).

Environmental

Home modifications – Remove home hazards and install assistive/protective devices.

• Remove home hazards and install assistive / protective devices.

• Remove boxes, newspapers, electrical cords and phone cords from walkways.

• Move coffee tables, magazine racks and plant stands from high-traffic areas.

• Secure loose rugs with double-faced tape, tacks or a slip-resistant backing or remove loose rugs from your home.

• Repair loose, wooden floorboards and carpeting right away.

• Store clothing, dishes, food and other necessities within easy reach.

• Immediately clean spilled liquids, grease or food.

• Use non-skid floor wax.

• Use non-slip mats in your bathtub or shower.

• Installing stairway protective device.

• Railing/grab bars.

• Good lighting.

It would certainly help if age friendly design in the public environment. Example of these:

• Barrier-free building and streets

• Adequate public transport

• Secure neighbourhoods

• Parking bays for elderly close to building and transport

• Safe and elderly friendly place for physical activity and exercise

Drugs

Older people tend to take more medicines than younger people and they are more prone to side effects because of altered mechanism of absorption and metabolism. Therefore they need to regularly:

• Have their medication be reviewed and modified by doctor.

• Consult with doctors to reduce the number of medications, simplifying the medication regime and take advice from doctors regarding self-prescribed medicines if any.

Medical Conditions

Medical conditions may be worsened by decline of physical, cognitive and affective capacities. Treating medical conditions aiming to resolve or minimize incapacities will reduce risk of fall. Below are among the medical conditions that need to be addressed:

• cardiac dysrhythmias and orthostatic hypotension

• reducing the number of medications, particularly those that contribute to postural hypotension or sedation;

• addressing gait and balance problems, with appropriate assistive devices;

• rehabilitation for weakness and mobility problems;

• vitamin D and calcium supplementation

• correctable vision, particularly early cataract surgery foot care and appropriate footwear

Nutritional Factors

Sensory and structural changes as results of aging may affect nutritional intake and health status of the elderly. Loss of smell and taste, reduced vision may affect appetite, loss of teeth may affect ability to chew food and reduced gastrointestinal function may affect the absorption of nutrients.

To improve appetite, elderly may try variety of new food flavours and textures; improve their vision through whatever possible means. They need to have good fitting dentures to improve the ability to chew food or adjust food presentations eg. chop, steam, stew, grind or grate hard or tough foods to make them easier to chew without sacrificing their nutritional value. They also need food supplements especially calcium and vitamin D.

Lack of exercise

Regular exercise and physical activities can contribute to healthy bones, muscles and joints. They will improve reaction time, mobility and balance and hence will lower the risk of falls and fall-related injuries. They will also prevent and delay the onset of multiple pathologies and functional capacity which may contribute to risk of falls.