Health

‘Ounce of Prevention’ is Key to Preventing Falls, Specialist Says

Listen to Dr. Brown's discussion:

A “Falls Clinic” might seem, at first, a place you go to recuperate after taking a tumble. But the clinic, directed by Cynthia Brown, M.D., of the UAB Center for Aging, takes a different approach. With the strategy of “an ounce of prevention” in mind, Brown and her colleagues help their patients explore ways of eliminating falls before they have a chance to happen.

“There are numerous factors that contribute to falling, some of which are fixable and others which are not,” Brown says. “So in our clinic we recognize the things that are not fixable, such as diabetes—not being able to feel your feet because have a neuropathy—but there's a long list of things we can fix, so we focus on those aspects.”

Among those “fixable” factors, according to Brown:

• Muscle weakness. Lack of leg strength is a major contributing factor to falls and disruptions of balance.
• Improper walking implements. “If you use a cane or a walker, has it been selected and adjusted for your needs,” Brown asks, “or is it one you've just borrowed from a friend or relative?”
• Medications and blood pressure. The side effects of many prescription drugs (particularly in combination) include dizziness or fluctuations in blood pressure, both of which can interfere with balance. In the Falls Clinic, patients' blood pressure is tested, both sitting and standing. Significant differences in the two may indicate that medication needs reevaluating in order to improve a patient's equilibrium.
• Safe shoes. Are the heels and walking surfaces of your footwear “sensible,” or are they geared more toward fashion than utility?
• Paying attention. Difficulties with vision and hearing aren't the only factors that prevent us from spotting hazards in our immediate environment. Chronic or clinical depression can also interfere with our clear perception of what's around us.
• Clutter and surprises: Though potential hazards such as loose throw-rugs get the most attention when fall-proofing an environment, Brown says research shows that such familiar objects are less of a threat than new intrusions. “Children who visit and leave toys on the floor, or pets that are apt to wander underfoot,” says Brown, “are much more frequent causes of falls.”

There's good news on the subject of fall prevention, according to Brown:

“The thing that has changed the most in recent years is our recognition of the problem, and the fact that there's been a significant amount of research done in this area in the last 20 years. We now know what makes a difference; we know how to keep people from falling. There have been excellent clinical trials to demonstrate that if you do the things we suggest, they can prevent you from falling.”

“I think that we, as a society, are recognizing not only that the problem is out there, but that there's something we can do about it. And that's quite exciting.”

A downloadable audio file of Dr. Brown’s article is also available.