Common Causes of Falls in the Elderly Essay Example

Introduction

Globally, the population of the elderly, people aged 60 years and above, is rapidly increasing compared to other age groups (Stamm, Leite, Hildebrandt, Kirchner, & Menezes, 2016; Hsiao, 2016).). Even though increased lifespan is laudable and is linked to global improvement in health, the aging population have unique challenges linked to the events that can result in disability at this stage of life. The most common factor that has been linked to disability at this stage of life is falls. More than 50% of the older adults have recurrent falls every year (Stamm et al., 2016).

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Falls, among the elderly individuals, has been associated with devastating health consequences such as temporary restriction of movement, due to the fear of falling again, failure to perform normal daily activities, increased dependence on others, fractures, and even death (Stamm, Leite, Hildebrandt, Kirchner, & Menezes, 2016). Jankowska, Jankowski, and Rudnicka-Drozak (2018) have also noted that the high prevalence of falls among older adults is a critical health problem that can result in severe injury and disability. In other instances, falls may be fatal because of chronic complications associated with aging. Because of falls and the resulting health impacts on the affected individuals, their quality of life is significantly reduced resulting in increased dependence, social exclusion institutionalization.

Because of the adverse health effects of falls in people aged 60 and above, falls is a public health concern which requires efforts to be channeled towards its reduction. Knowledge of the factors that increase the risk of falling is one of the most critical steps in efforts to address the problem. An examination of the past studies on falls in the elderly population reveals that it is caused by multiple factors. The three most important factors linked to elderly falls include physiological changes, medical condition, and environmental factors (Bell, Steinsbekk, & Granas, 2017).

Purpose of the Study

The purpose of this study is to explore the factors associated with increased risk of falls among older adults.

Research Question

What the factors associated with increased risk of falls among older adults, aged 60 years and above?

Materials and Methods

The present study will explore that factors linked to increased risk of falls among the elderly. This will be done by carrying out a literature search of past studies that have examined the topic and presenting the findings. The findings of the literature search will be presented thematically. The results of the literature review revealed three common themes associated with increased cases of falls in older adults: physiological changes, medical condition, and environmental factors

Factors Linked to Falls in Older Adults

Medical condition and Elderly Falls

Medical conditions have been found to lead to increased falls among the elderly. For instance, according to Stamm et al. (2016) falls are caused by the use of medicine, use of glasses, and impaired vision. Also, the authors reported that falls were more prevalent among individuals with chronic medical conditions such as cardiovascular disease and osteoarticular. Additionally, falls have been found to be caused by cognitive decline. Cognitive impairment and its association with falls are not associated with the attendance of formal education. The issue of medication and its relationship with increased risk of falls has also been addressed in Bell, Steinsbekk, and Granas' (2017) study. Bell et al. (2017) explored the perception of fall risk among home-dwelling elderly who use fall-risk increasing drugs and how the perception is related to their use of the drugs. Findings of the study revealed that the elderly participants who linked their drug use to fall risk linked their falls to increased dizziness or reading of the patient information leaflets (PILS). In the case of reading of the PILS, concerns about the side effects of the drugs frightened the elderly (Bell et al., 2017).

In a related study, de Almeida Pires-Oliveira et al. (2014) noted that even though there is no relationship between predictor test of falls and mental components of quality of life, increased physical activities among the elderly can help reduce the risk of falls by alleviating cognitive decline. Additionally, physical activity helps reduce falls by reducing mobility limitations that compromise their quality of life. This increases their independence, especially in daily life activities, and also alleviates the fear of falling back. Decreased risk of falling in physically active older adults has also been linked to improved physical posture and mobility (de Almeida Pires-Oliveira et al., 2014).

Further, medical conditions that have been found to increase the risk of falling include the presence of balance disorders and muscle weakness caused by failure to have adequate levels of physical activities. Other medical factors include the concurrent use of five or more medications (polypharmacy), use of psychotropic drugs, walking difficulties, dizziness, and depression (de Almeida Pires-Oliveira et al., 2014). Kaminska, Brodowski, and Karakiewicz (2015) has also linked increasing cases of falls among the elderly to depressive symptoms, loss of sight, and increased anxiety. Jankowska, Jankowski, and Rudnicka-Drozak (2018) further established that rising cases of falls among the elderly are caused by modifiable risk factors of falls such as polypharmacy. Also, Chen (2016) has reported that falls are caused by intrinsic factors such as dizziness or vertigo, the presence of medical conditions such as stroke and cancer, impaired vision, and psychoactive medication use. Because of the risks of falls associated with the use of psychoactive medication, there is a need to minimize the use of psychoactive drugs among the elderly (Chen, 2016).

Physiological Factors and Falls in Older Adults

Falls among older adults have been linked to different physiological factors. According to Kaminska, Brodowski, and Karakiewicz (2015), functional status is an important factor in falls. There is a negative relationship between functional status and the frequency of falls. That is, higher functional status is linked to a lower a number of falls. Also, affective functioning is correlated with the increased rate of falls. That is, disturbed gait and balance, conditions typical in individuals with advanced age impair their capacity to maintain their body balance thus leading to increased falls. Additionally, older adults with higher cognitive status have been reported to have fewer falls than their lower cognitive status counterparts.

The Sensory Organization Test (SOT) has also been carried out to identify problems related to postural control by evaluating the older adults' ability to use visual, vestibular, and proprioceptive information effectively. In one of the studies, Faraldo-Garcia et al. (2016) found out that older adults with high risk of falls have a higher reaction time, lower excursion, poorer directional control compared to their healthy counterparts.

Environmental Factors and Elderly Falls

Many factors have been linked to falls among the elderly. According to Stamm et al. (2016), environmental factors linked to falls in the elderly population include inadequate domestic environment characterized by the presence of stairs in residential areas, lack of handrails on the stairs, absence of non-slip flooring on the stairs, and absence of signals in the ladder. In the home environment, increased falls have also been attributed to non-slip tile floors, carpets and smooth surfaces, the use of slippers that have slippery soles, and the use of armless chair.

Even though environmental factors have been linked to fall risks, Chen (2015) opines that environmental hazards alone are inadequate to cause falls. Chen (2015) explained that falls often occurs because of the interaction between environmental risk factors and behaviors involving the use of the environment. For instance, even though Chen (2015) linked increased risk of falling to use of walk aid, the author noted that older adults with moderate to high levels of activity have lower risks of falls if walking aids are used during the activities.

In a related study, Northridge, Nevitt, Kelsey, and Link (1995) found out that incidences of falls among the older adults are associated with the presence of home hazards such as hall rug problems, clutter, and storage problems. In this study, Northridge et al. (1995) further found out that frail older adults are more likely to experience falls compared to their vigorous older counterparts. The high prevalence of falls in frail older persons was linked to repeated falls and compromised function (Northridge et al., 1995). To decrease environmental-related falls in older adults, exercise interventions should be emphasized in older adults (Chen, 2016).

References

Bell, H. T., Steinsbekk, A., & Granas, A. G. (2017). Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use - a qualitative study. Scandinavian Journal Of Primary Health Care, 35(3), 247-255.

Chen, T. Y., Jerri D. Edwards, & Megan C. Janke. (2013). The Effects of the A Matter of Balance Program on Falls, Physical Risks of Falls, and Psychological Consequences of Falling among Older Adults.

de Almeida Pires-Oliveira, D. A., Gil, A. O., de Oliveira, L. C., Bento, F. M., Mendes, C. T., & dos Santos, J. M. (2014). Analysis of quality of life in elderly practitioners of physical activity and relationship with risk of falls. Manual Therapy, Posturology & Rehabilitation Journal, 12(1), 143-148. doi:10.17784/mtprehabjournal.2014.12.181

Faraldo-Garcia, A., Santos-Perez, S., Rossi-Izquierdo, M., Lirola-Delgado, A., Vaamonde-Sanchez-Andrade, I., del-Rio-Valeiras, M., & Soto-Varela, A. (2016). Posturographic limits of stability can predict the increased risk of falls in elderly patients with instability?. Acta Oto-Laryngologica (Supplement), 136(11), 1125-1129.

Hsiao, P. D. H. (2016). Fall Prevention and Protection: Principles, Guidelines, and Practices. Boca Raton: CRC Press.

Magdalena Sylwia, K., Jacek, B., & Beata, K. (2015). Fall Risk Factors in Community-Dwelling Elderly Depending on Their Physical Function, Cognitive Status and Symptoms of Depression. International Journal Of Environmental Research And Public Health, Vol 12, Iss 4, Pp 3406-3416 (2015), (4), 3406. doi:10.3390/ijerph120403406

Northridge, M. E., Nevitt, M. C., Kelsey, J. L., & Link, B. (1995). Home Hazards and Falls in the Elderly: The Role of Health and Functional Status. American Journal Of Public Health, 85(4), 509-515.

Paula, J., Krzysztof, J., & Ewa, R. (2018). Elderly falls, multifactorial medical problem - how to assess the risk?. Journal Of Education, Health And Sport, Vol 8, Iss 9, Pp 61-68 (2018), (9), 61. doi:10.5281/zenodo.1326392

Pei-Hao, C. (2016). Elderly Falls in Hospitals. International Journal Of Gerontology, Vol 10, Iss 3, P 125 (2016), (3), 125. doi:10.1016/j.ijge.2016.06.001

Stamm, B., Leite, M. T., Hildebrandt, L. M., Kirchner, R. M., & Menezes, L. P. (2016). Falling is a part of life: Falls risk factors to the elderly. doi:10.9789/2175-5361.2016.v8i4.5080-5086