When an elderly person has a fall, it could possibly spell the beginning of the end.
But if the person picks up where she left off before the fall, she can minimise the risk of other illnesses or disorders. What worries doctors about senior citizens, is not so much falls as inactivity. Senior citizens who do not get any physical exercise, slowly but steadily lose their muscle strength. Sometimes, they become bed-ridden simply because they did not exercise their limbs.
Geriatrician G. Usha, assistant professor at Madras Medical College (MMC), says high-risk behaviour among senior citizens could also cause falls. She recalled that a 70-year-old woman who sportingly climbed a stool to reach the attic had trouble getting down, causing her daughter to panic.
Though genetics play an important part, regular exercise, good dietary habits and a stress-free mind can prevent the risk of falls says B. Krishnaswamy, head of the geriatrics department, MMC. “Falls are more common among those over the age of 70, especially if they restrict their activities. Senior citizens must exercise. Simple exercises like walking outside, housework and yoga can keep the muscles active,” says the geriatrician recalling that a 90-year-old patient would come unaccompanied to the outpatient ward of the general hospital attached to the college for simple ailments like coughs and colds.
“There was a man who used to come to the hospital for 12 years. He would complain of a cold and cough. I last saw him when he was 95. He was always cheerful and would take a bus to get here,” Dr. Krishnaswamy said.
Four years ago, the nonagenarian opted to return to Gujarat. “He was complaining of a lack of understanding among his grandchildren and so chose to move in with another of his children,” the doctor said.
According to a publication by the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention, United States, in 2009, about 20,400 senior citizens died from unintentional falls in the United States. Though there is no specific data for India, doctors say, even in India, 95 per cent of hip fractures in senior citizens are due to falls and in these cases, women outnumber men.
Regular exercise can help prevent a fall, but it is equally important to exercise after a fall. A lack of muscle coordination can develop as a result of not using the limbs, particularly after a fall.
The geriatrics department at Madras Medical College conducts some simple tests on the elderly to assess their balance and coordination. The elderly person undergoes a “get up and go” test in which the healthcare provider times the speed with which the senior citizen completes the task.
Another test involves asking the patient to stretch each arm as much as she can. The patient is then asked to try and stand on one leg. These tests are timed and doctors can calculate the extent of risk for falls.
Geriatricians suggest that these simple tests can be taught to general practitioners or healthcare providers and they can safely conduct thems on senior citizens. Ideally these tests should be conducted when the person has reached the age of 60, and periodic follow-ups must be done to assess their health.