The University Record, June 21, 1999

Old age and falling: They don’t always go together

By Pete Barkey
Health System Public Relations

Jodi Medell (left) observes Virginia Burr to see whether she has any difficulties maintaining her balance during a number of exercises. Balance difficulties often lead to falls that are wrongly attributed to old age, according to research by Neil Alexander, director of the Mobility Research Center. Photo courtesy Neil Alexander
Researchers say one should no longer assume old age is to blame when grandma falls in her kitchen. U-M physicians have found that they can work with older people to reduce their risk of falling by improving their coordination and balance.

Falls and their damaging after-effects are the leading cause of accidental death in people over age 65. One-third of people age 65 and older fall every year, sometimes resulting in fractured or broken bones. One-half of those over age 80 fall. Falls also exact a financial toll, costing about $3 billion per year in medical treatment.

A host of explanations may point to problems with mobility and balance, doctors say. And that is good news for older people who have become so afraid of taking a bad fall that their sense of independence is threatened.

“We previously had not looked into falls because we thought perhaps this is just a part of age. It’s not a part of aging. Falls are a manifestation of something wrong with the person,” says Neil Alexander, director of the Mobility Research Center. “Balance disorders and falls are not often recognized as an important problem because a number of us younger people fall as well. When an older adult falls, they’re more likely to have a major injury and, in fact, they tend to fall more often,” he adds.

Alexander studies and treats balance disorders, which may have a variety of causes and typically become apparent with a fall. A person with a balance disorder has a high frequency of falls, perhaps twice in a six-month period.

“More important, these falls tend to be more injurious—the people tend to hurt themselves more. And the person tends to be quite conscious of these falls and develops a fear of falling,” Alexander says.

The first step is to examine a person’s medical condition and possible physical problems—vision, inner ear, joints, strength and sensory functions. Next comes a plan for physical therapy, particularly a process known as balance training. “Physical therapy,” Alexander notes, “is the cornerstone of fall management.”

Also key to keeping older people on their feet is improving cognition—working on their awareness of surroundings and any physical obstacles they may face in moving about. For example, people are taught to focus on a cracked or uneven sidewalk, giving it their full attention and not being distracted while walking.

“One way to get older adults to be more aware of the situation and be more attentive to their environment is to train them on irregular surfaces, and to train them on the type of challenging surfaces they might see in their environment,” Alexander says.

Other exercises involve improving stance and learning to step rapidly, which can help prevent a fall. Alexander also stresses making changes at home to decrease the chances of falling. They include removing loose rugs or adding no-skid pads, using nightlights, placing non-skid strips in the bathtub or shower stall and improving outdoor lighting.

To find out more about balance disorders and falls, call Telecare, (800) 742-2300, category 1010, or check the Web at www.med.umich.edu for these topics: Home Falls; Home Falls Prevention; M-CARE Safety Tips for Home; and Osteoporosis and Related Bone Disease, National Resource Center–Fall and Fracture Prevention.