5 - Falls Flashcards
What should you use instead of calling a fall a mechanical fall?
All falls are mechanical - try to think in terms of cause and consequence instead
Why are falls important?
They are the most common cause of injury related death in people over 75.
Also far more common presentation than anything else.
What can impede our ability to walk without falling?
Why do older people fall?
Age related changes
Co-morbidities - inc meds
Environment
What neurological changes in older age can be associated with increased risk of falls?
Loss of neurons + demyelination of neurons => lower processing speed
Sensory impairment
Impairment of the vestibular system
What eye changes in older age can be associated with increased risk of falls?
Deterioration of acuity - both static and dynamic
Slower reactions to changes in lighting
Reduced colour contrast sensitivity
Long sightedness
How can changes to posture in older age result in an inc risk of falls?
Posture changes => centre of gravity is moved forward
Means Ps are more off balance and can inc risk of fall
What areas of co-morbidity should you be aware of when assessing inc risk of falls?
Balance/Gait
Visual Impairment
Cognition
CV
Incontinence
Anaemia
What is the most common cause of falls?
Incorrect shifting of bodyweight
Much greater prevalence than LOC of collapse!
Which medications are commonly associated with an increased falls risk?
Benzodiazepines, Hypnotics, Sedating antidepressants, Opiates, Anti-epileptics,
Alpha-blockers, Diuretics, Beta blockers, ACE inhibitors = postural hypotension
Sedating antihistamines and many more
High anticholinergic burden drugs
Why can anticholinergic burden drugs inc the risk of falls?
- Can cause cognitive impairment, blurred vision, dizziness and vertigo, can affect neuronal control of muscles & orthostatic hypotension.
What are the possible morbidity and mortality risks associated with falls?
Who should have a multifactorial falls assessment?
Anyone presenting for medical attention because of a fall
OR
have fallen 2+ times in past year
OR
have abnormality of gait/balance
When assessing a P - what things can you check for to identify fall risk factors?
Which exercise programmes are good for Ps with fall risk factors?
Tai Chi
Otago
