JILLIAN CONERLY

All over the nation, falls are a topic of concern. According to the Centers for Disease Control and Prevention, one in four Americans fall each year. Older adults aged 65 years and older are at a high risk for experiencing a fall. In fact, fall risk increases by 50% for those aged 80 years and older. Since more than 10,000 Americans turn 65 every day, falls are becoming a tremendous public health concern.

Overall, we know that there are several factors that contribute to the reasons why people fall. These factors include a person’s physiology, behavior and environment. Physiology is a fancy term used to describe how the different parts of the body interact with each other. For various reasons, people can have muscle weakness, problems with balance, walking and vision impairment. Aside from a person’s physiology, behavior is another factor that plays a role in a person’s risk of falling. Behavior is comprised of three different components including cognitive behavior, medication usage and physical activity level.

Cognitive behavior refers to our ability to understand situations and how we make decisions regarding our safety. The second component of a person’s behavior is their medication usage. Taking medications can affect our behavior, and we know that someone who takes four or more medications is at a higher risk of experiencing a fall. In fact, individuals who use psychoactive medications (mood altering) are at a greater risk of experiencing a fall.

The final component of a person’s behavior refers to the individual’s physical activity level. Being physically inactive or sedentary is a common behavior that many people exhibit when they have a fear of falling. This fear of falling can cause a person to limit their activity level and become isolated. Being sedentary can cause many of the impairments previously discussed regarding physiology. It is a vicious cycle.

The last factor that contributes to a person’s fall risk is the individual’s environment. When it comes to fall prevention, there are many safety hazards in the home including poor lighting, clutter, rugs and even animals! Whether there is not enough light to see the obstacles, no handrails or grab bars to hold onto for balance, or unpredictable animals to avoid tripping over, the home presents many fall hazards.

However, there is good news! Every component of risk is manageable in some way. The first way to manage your fall risk is by talking to your doctor about medication and vision changes that you may be having. The risk factors that we have more control over are our environment and activity level. In order to create a safe environment, consider de-cluttering your home, replace broken or dimly lit light bulbs, discard any throw rugs, and secure all other rugs to the floor with adhesive tape. In addition to making changes within your home to reduce the risk of falling, you must make changes within your daily life to incorporate physical activity and exercise. All adults need to participate in at least 150 minutes of moderate-to-vigorous intensity physical activity, or MVPA, on a weekly basis to derive the associated health benefits. For older adults, weekly MVPA minutes must include a variety of strength, balance and aerobic activities.

Sometimes, changing your lifestyle to be more physically active can be overwhelming. Specifically, if you have physical difficulties or impairments, you may be concerned about your safety when learning how to exercise. However, there are specific tailored exercise programs to help you make these necessary lifestyle changes. The Otago Exercise Program is a progressive strengthening, balance and walking program that is used to improve mobility and reduce fall risk. This evidence-based program is specifically geared towards older adults who have a fear of falling, have fallen in the past year or are interested in learning how to prevent falls. Results from four randomized control trials showed that the OEP significantly reduced falls in older adults compared to inactive control groups.

Currently, Vidant Beaufort is in the process of implementing this program within a few departments to better service our patients in eastern North Carolina. The Wellness Center, physical therapy and the local assisted-living communities have adopted the program. If you are interested in participating in the program, please ask your doctor about referral options. If you are cleared by your physician to exercise, then you can be referred to the Exercise Is Medicine program at the Wellness Center. However, if you need to undergo PT, your OEP can begin within your PT treatment, as well! If you are wondering whether or not you are at a high risk of experiencing a fall, please complete the Stay Independent brochure located on the CDCP website. If you are interested in learning more about the OEP, or other opportunities related to the program, please feel free to contact me directly.

Jillian Conerly, exercise physiologist II of Vidant Wellness Center, Washington, can be reached by calling 252-975-4236 or emailing Jillian.Conerly@VidantHealth.com.