Older persons are more likely
to have impaired physiological reserves and are
also more likely to suffer from chronic medical
conditions such as hypertension, diabetes mellitus
and heart disorders. These conditions, together
with the impact of acute illnesses and adverse
effects arising from polypharmacy, can result
in progressive weakness and impaired mobility.
Worsening mobility, especially if it is of recent
onset, can also be a portent of an underlying
medical problem that needs to be assessed and
addressed. Some of the common causes of worsening
mobility are amenable to treatment and can potentially
be cured.
The incidence of falls increases with age and
studies have shown that as much as one third of
healthy community-dwelling older persons fall
every year. It is also known that older persons
who have had a first fall during the preceding
year are more likely to fall again.
Falls in older persons are associated with serious
physical injury in less than 10% of the time.
Examples of such serious injuries include fractures
and serious head injuries. However, more than
50% of older fallers can be psychologically traumatized
by their falls and develop a state that is often
referred to as "fear of falling". Fear of falling
can then lead to a progressive decline in mobility,
together with its associated complications (such
as pressure sores, incontinence, constipation
and infections), depression and social isolation.
As in the case of many other "geriatric syndromes",
falls can arise from an interplay of many conditions
and environmental circumstances. These may include
acute illnesses such as infections, impaired cognition,
poor vision, medication side effects or even poor
footwear. Occasionally, falls may arise because
of a general state of frailty that has arisen
because of multiple co-existent chronic conditions.
Studies have shown that older persons who have
had recurrent falls may benefit from thorough
assessment by suitably trained personnel and subsequent
targeted interventions.
If you or your relatives have had recurrent falls,
you may benefit from an assessment by your doctor.
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