Today’s society is more active than ever, but inevitably every year more than two million Americans fall and sustain serious injury, costing the healthcare system in excess of $3 billion dollars. Hidden costs affecting the individual include pain, disability, lawsuits, loss of independence, deterioration in well-being, and the impact on other family members. Nonetheless, falls are predictable and preventable, even for older adults.
Falls and the resulting injuries are among the elderly’s most serious health issues caused by the body’s deterioration through inactivity and the central nervous system (CNS)’s damaged through injuries. For example, the sensory cells in the ears’ balance system gradually decrease and cannot be replaced, as well as the nerves carrying sensory information to the brain to perform complex brain interconnections lose fiber and nerve cells. In addition, nerve endings loose their ability to generate the chemicals responsible for the transmission of information. This process accelerates after the age of 50.
Many diseases affect the CNS and sense organs too. Also, muscle strength gradually decreases with age, joint tendons and ligaments lose their flexibility and limit motion. The combined ravages of bone and joint injury, arthritis, and inactivity can result in a body that cannot carry out motion commands initiated by the brain. Hardening of the arteries is probably the worst. It is accelerated by high blood pressure, smoking, and diabetes. Although artery hardening gradually increases during middle age, there is a point at which a slight additional decrease in blood flow causes serious vascular impairment such as stroke.
Head injuries, sometimes caused by falls, can damage the sense organs in the inner ears, or the brain itself. Therefore, physical activity is very important for injury recovery to the sensory systems. The general debility of aging can negatively affect recovery if it results in a decreased level of activity. Often, injuries to the knees, hips, and back do not completely heal, leaving some limitation of motion.
The worst disability occurs when both sense organs and CNS structures are damaged simultaneously, as is the case with Alzheimer’s Disease. Also, arthritis can cause permanent, crippling, nonreversible effects and osteoporosis can lead to bone weakness and increases the probability of serious injury from a fall or a spontaneous fracture that might lead to a fall.
In this time of specialization, it is possible for one patient to receive prescriptions from several physicians that might have additive side effects on the brain and sensory function. Therefore, patients should keep a complete list of all their medications and dosages, and make this list available to each physician they consult. Coordination of all medications through a single primary care physician would help avoid adverse drug reactions to the brain and sensory functions. The list should include:
Rehabilitation includes increasing the range of motion as well as physical strength. A very important part of rehabilitation is overcoming the fear of falling and thus avoiding further injury. Walkers and canes can aid stability, while simple changes in the home, such as installing hand holds in bathrooms or along walls, could decrease the likelihood of falling and increase confidence. But keep in mind, drastically changing a familiar environment often hampers recovery. As soon as possible, rehabilitation should include family members and home support groups. Rapid return to physical activity and social interaction with family and community can often stop the vicious spiral into inactivity, reclusiveness, and progressive deterioration that falls and injuries cause.
As many of the problems responsible for falling develop during early and middle age, initial efforts to prevent injuries should begin at a younger age. Many of the changes in muscle, bone, and the central nervous system are not inevitable results of aging, but are brought on by inactive lifestyles and self-inflicted damage from smoking, poor diet, and lack of exercise. Although hardening of the arteries is occasionally hereditary, in most cases it can be reduced by diets low in cholesterol and saturated fatty acids, as well as regular physical exercise.
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25500 Meadowbrook Road Suite 220, Novi, MI 48375