Preventing Falls in the Elderly
Every family with elderly members faces the problem of falls. In addition to the pain of the fallen person, there is also the need of care which costs time, money and effort. We all wish we could do more to prevent these falls and at least reduce their incidence as it is impossible to totally avoid them.
Bone mass through lifespan
When we are young we usually don’t think much about our bone density, osteoporosis, falls related to ageing etc. We just think that as we grow, bones are getting stronger and only after the age of 65 we should consider our bones health. What happens through the lifespan is that bone mass increases during childhood and there is an accelerated phase of bone gain in adolescents. We reach the peak bone mass between the age of 20–25 and these levels remain static until the age of 45 when bone density starts to fall. Women experience a more rapid decrease of bone mass after the age of 50, because of their hormone changes at the menopause. Women hormones like the estrogen are not the only hormones involved in bone mass, but growth hormone, testosterone and thyroid hormone, are also important. Genetic factors also play a key role in bone mass and bone loss. Additional, factors influencing peak bone mass are intake nutrients such as calcium and vitamins and exercise. (1)
The decrease of bone mass is followed by an increased risk of osteoporosis, fractures and falls.
Falls in the UK
About 30% of the England’s elderly over 65 experience a fall at least once a year. (2) About 50% of individuals aged over 80, experience a fall at least once a year. (3) In a study (2008) conducted in the Nottinghamshire area, from the emergency calls recorded and involved the elderly, about 40% of the cases were recorded as falls. (4) Falls are the most frequent and serious type of accident in the elderly. In addition, they are one of the main causes of disability (fractures) and a potential cause of death from injury (especially head injuries) among people aged over 75 in the UK. Falls have a tremendous economic impact and cost the NHS more than £2 billion per year. Moreover, falls affect productivity costs in terms of career time and absence from work. (2)
Falls in the elderly and causes
According to the World Health Organization, a fall is usually defined as “an event which results in the person coming to rest inadvertently on the ground or other lower level, and other than as a consequence of the following: sustaining a violent blow, loss of consciousness, sudden onset of paralysis, or an epileptic seizure”
There are several factors that cause falls in the elderly:
- Medical conditions such as diabetes, arthritis, visual impairments, blindness etc.
- Impaired mobility and gait. The decline in muscle mass and strength that characterize the elderly, makes them unable to prevent a slip, trip or stumble becoming a fall.
- Sedentary life: Fallers tend to be less active and this results to muscle atrophy.
- Impaired cognition
- Foot problems like ulcers or pain in walking decrease balance and stability and increase risk of falls.
- Nutritional deficiencies: Malnutrition and Vitamin D deficiency are the most common and lead to muscle mass loss, osteoporosis etc. (3)
Nutrition and lifestyle modification to avoid falls
Exercise is important in reducing risk of falling and rate of falls. It helps you gain and maintain muscle and bone mass. The recommended types of exercise aim on balance retraining and muscle strengthening. Weight training is the type of exercise that is more beneficial for the bones. (5)
No matter how hard you exercise, your body needs the appropriate nutrients to prevent your bones and to manage to avoid falls. Here are some of the most important nutrients that will help you avoid falls:
Dairy products are the main sources of calcium. Studies have shown that oral calcium supplementation is effective for the prevention and treatment of bone loss and osteoporosis. Additionally, some studies have reported a significant positive effect of calcium supplementation on fracture incidence. (6)
According to a recently published study (2016), a threshold of serum Vitamin D around 30 ng/ml is necessary for the prevention of hip bone loss. Since the main source of Vitamin D is the sun, it is important to take food supplements or fortify foods with the Vitamin D, especially during the winter and in areas with low sunlight exposure. (7)
The role of Vitamin K2 is to activate osteocalcin which is crucial for the bones. In Europe, vitamin K2 supplements are in the form MK7. You can include fermented cheeses in your diet to get Vitamin K2, but this provides a small amount of the vitamin. (8)
Magnesium is involved in bone formation and its deficiency is considered as a risk factor for osteoporosis. (9) In a study conducted in 2010, researchers investigated the effect of magnesium supplementation in postmenopausal women with osteoporosis. They concluded that oral magnesium supplementation in postmenopausal women with osteoporosis, suppresses bone turnover. (10)
There are human studies reporting a link between omega 3 fatty acid consumption and bone health. Specifically, a high consumption of fish (which are a great source of omega 3 fatty acids) was associated with a reduced Bone Mineral Density loss. (11)
It is a carotenoid found in salmon, shrimp and other foods. It is a great antioxidant and helps you reduce inflammation. Some people who are allergic to food sources of astaxanthin or just don’t like these foods, should consider taking a food supplement. (12)
Falls are a serious public health problem. They are mainly observed in the elderly but the preventive actions you can do, can start since you are a teenager. Your lifestyle should include regular exercise and a balanced healthy diet. Older people don’t pay much attention on their eating habits and don’t have the knowledge to choose the right foods. Food supplements can contribute on their diet and offer some missing nutrients such as vitamin D, K2, calcium and others, which may also offer synergistic effects and not only prevent falls but also provide additional health benefits.
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