Many Older Adults Fall at Home in Well-Lit Rooms

By Lisa Rapaport

(Reuters Health) - Elderly people who fall may not always be stumbling over things in the dark. A new study suggests most of these falls at home happen when there's plenty of light.

Falls are a leading cause of disability and diminished quality of life among older adults, but much of the research to date on the underlying causes of these incidents has relied on medical records that don't illuminate exactly what led to the accident, researchers note in a report in the Journals of Gerontology: Series A, online May 4.

The researchers examined data from weekly online surveys of older adults to get a detailed picture of what factors contributed to 371 falls reported over a four-year period. The study included 120 people who fell at least once, as well as 38 who did not.

Most falls happened at home, often in the bedroom, the study found.

"Older people generally fall in their common rooms and in situations that seem unlikely for the simple reason that they spend too much time at home (the more you walk, the less you fall, paradoxically; balance, strength and body awareness are better with more activity)," said lead study author Dr. Antoine Piau of Oregon Health & Science University in Portland and the University Hospital of Toulouse in France.

Four out of five falls in the study happened in well-lit areas, suggesting the problem isn't that people can't see where they're going.

Instead, it seems they may be trying to do too much at once, Piau said by email.

"Falls at home may also be common because people in their everyday activities are doing more than one thing at a time without being attentive to their environment such as walking down stairs while carrying a box or phone," Piau said by email.

Stairways were not a common location for falls, with only seven falls, or 2 percent of the total, occurring on stairs.

Almost 90 percent of falls occurred because people lost their balance, and nearly two-thirds involved a slip or trip as the precipitating factor.

Overall, 119 falls led to an injury or a checkup with a healthcare provider. One in five of these falls, however, didn't result in treatment or have any impact on walking.

Nineteen falls, or 8 percent, resulted in reduced walking ability.

The study wasn't designed to prove whether or how specific circumstances cause falls. It also didn't examine ways to prevent falls or minimize risks of injury.

"Falls happen where people spend most of their time," said Dr. Eric Larson of Kaiser Permanente Washington in Seattle.

"But in addition to location, there may be circumstances, like the common need to go to the bathroom, especially after waking up during sleep, that contribute to falls," Larson, who wasn't involved in the study, said by email. "This is a prime time for falling for a number of reasons – (including) slippery floors and lack of any footwear."

Staying active can also help, said Cathie Sherrington of the Institute for Musculoskeletal Health at the University of Sydney in Australia.

"An exercise program to enhance balance and strength has been found to prevent falls," Sherrington, who wasn't involved in the study, said by email.

When people do fall, they should have their home assessed for potential trip hazards to help avoid another accident, advised Dr. Sharon Straus of St. Michael's Hospital and the University of Toronto in Canada.

"Falls can result in injuries that impact mobility, even though hospitalization may not be required," Straus, who wasn't involved in the study, said by email. "It would be useful for patients to be assessed after a fall to optimize their functional status and address factors that could prevent future falls."

SOURCE: https://bit.ly/2XneGMl

J Gerontol Series A 2019.

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