Citation

Atay E, Akeniz M. GeroFam 2011; 2(1): 11-28.

Copyright

(Copyright © 2011, The authors, Publisher ScopeMed-GESDAV)

DOI

unavailable

PMID

unavailable

Abstract

Falls among older adults are a crucial problem that affects the quality of life of the elderly population significantly and increases the health care burden and cost of states. As people get older, they may fall more often for a variety of reasons including problems with balance, poor vision, and dementia. About a third of community-dwelling people over 65 years old fall each year, and the incidence of falls, and fall- related injuries, increases with age. Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma. However, many falls are predictable and preventable. Family physicians caring for older patients should integrate fall assessment into the annual history and physical examination. They should question the history of a fall if older patients don’t explain it. The risk of falling should be assessed for all elderly patients and precautions taken if necessary. Although falls may not result in injuries, they can nevertheless result in fear of falling and loss of confidence. This fear and loss of a sense of self-sufficiency may cause the elderly to restrict their activities, leading to reduced mobility and physical fitness, and increasing their actual risk of falling. There are many risk factors for falls among older seniors. Risk factors for falls can be classified into two categories: intrinsic factors and extrinsic factors. Most falls result from a complex interplay of predisposing and precipitating factors in a person's environment. Environmental hazards are preventable by relevant measures. Muscle weakness and poor balance have been well established as intrinsic risk factors for falling in elderly. The other risk factors include the use of an assistive device, visual deficit, arthritis, impaired activities of daily living, depression, cognitive impairment, and age older than 80 years. Dizziness, vertigo, drop attacks, postural hypotension, visual impairment are also known to cause falls. There is good evidence for the benefit of exercise in preventing falls. Physical activity appears to be associated with a reduced risk or slower progression of several age-related conditions which increase the risk of falls among elderly. Regular participation in physical activity is not only integral to the maintenance of good health and functional independence in older adulthood but will also lower the risk for falls and fall-related injuries. Depending on the level of fall risk identified, physical activity may serve a primary, secondary, or tertiary role in the prevention of falls. Its primary role is to prevent the onset of pathology and system impairments that may lead to disability and heightened risk for falls. İts secondary role is in slowing the progression of disease and system impairments. Its tertiary role lies in the restoration of function to a level that allows for more autonomy in the performance of daily activities. Regular participation in moderate physical activity is integral to good health and maintaining independence. It prevents the onset of multiple pathologies and functional capacity decline. Moderate physical activities and exercise also lowers the risk of falls and fall-related injuries in older age through controlling weight as well as contributing to healthy bones and muscles. Exercise programs should be tailored according to fall risk and the condition of older persons and should consist of four main types of exercise for preventing falls: endurance activities, strengthening exercises, stretching exercises and balance exercises. Individually tailored programs that included muscle strength development, balance improvement, and walking significantly reduced falls in older persons. Promoting appropriate physical activities or exercises to improve strength, balance, and flexibility is one of the most feasible and cost-effective strategies to prevent falls among older adults in the community.

Key words: Aged, Accidental Falls, Exercise, Postural Balance, Resistance Training, Fear