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Falling down is scary. It’s even scarier when you’re in your 70s or 80s. Many people, however, have issues with falling as they age.
There are lots of reasons for this, according to Dr. Laura Longwell, an internal medicine specialist at the UCHealth Primary Care Clinic – Rockrimmon in Colorado Springs. Many, perhaps the majority, of her patients are age 55 and older. As a physician who cares for people who are older, she is acutely aware of the statistics from the National Council on Aging (NCOA) website:
“There are two camps here,” Longwell said. “There are some things you can’t control, like slips and trips that happen to people at any age. Maybe you’ve had the flu or are dehydrated and you pass out and fall. A sinus infection can throw off your balance and you might fall. These can happen to anybody. So we’re all at risk, at any age.”
As we approach those golden years, about age 65 or so, other factors also start to figure into the equation.
“At that point, things that lead to falls include impaired vision, hearing and balance.”
“Vision is one of our senses and tells our brain where our body is in space. Hearing also contributes to that. The ‘hearing nerve’ does two things. Hearing is just one of them. It’s also a balancing nerve. Being able to see and hear well affects our sense of balance. Cataracts and other vision issues can play into the problem.”
A common complaint of aging patients is a numbness in the feet. It’s called neuropathy, and idiopathic neuropathy (no distinct identifiable cause) can be a factor, she said.
“If it’s present, you can’t feel your feet as well as you once could. That can increase falls.”
“I would argue that (if you have chronic pain) you are at a higher risk of falls. It can be very distracting. It can change how we walk, if we are hurting. So that affects gait and balance impairment. If my back hurts and I can’t stand up straight, I might lean forward and throw off my center of gravity. That can lead to falls,” Longwell said.
We have nerves that perform the job of helping us keep our balance – what’s called proprioception. Simply defined, it refers to the brain’s ability to perceive what’s going on in the body.
“It’s our ability to maintain balance and correct it when we have an imbalance,” she said. “The brain has to compute quickly how to correct balance, but as we age, the brain’s response to an imbalance signal might be slower.”
“Patients with dementia have a high fall risk. That’s because your brain’s processing speed is slowed down,” she said.
Those are all intrinsic risk factors, Longwell noted, “that are happening inside your body and you can’t control them. That’s especially true for older population.”
“There are things we can do to intervene and drastically reduce falls,” Longwell said.
For one thing, “doctors need to check everything from ears to toes,” she added. If a patient is falling, doctors check the effects of medications that a patient is taking. “We look at anything that might affect balance or alertness and address that appropriately,” Longwell said.
She periodically checks hearing, but she also checks her patients’ feet.
“We ask them to take their socks off and check them. Ask: ‘Can you feel them?’ Look for hammertoes and other deformities. Those can affect their gait,” she said.
To once again quote the National Council on Aging, “Falling is not an inevitable result of aging.”
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