Page 26 - mediscene nov19

MEDI SCENE
Do we afford Falling?

Dr Kanta Bhootra

Dear Friends, Do we afford Falling?
Not at all!
To kids, we always tell, 'Fell down, got injured, don't worry, that will make you stronger',
but for adults I always say,` Not at all! You can't afford falling'.

Before that let us see common causes of falls in elderly patients.
The lower limb joint problems are quite common, causing imbalance on uneven surface.
But before blaming joints we have to find out all the probable causes.
Poor vision, hearing defects, slowing of reflexes, hearing etc can cause imbalance.
Neurodegenerative disorders, myopathies, neuropathies also contribute to falls.
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Peripheral neuropathy associated with diabetes, alcoholism, vitamin B deficiency may
contribute to fall mostly at poorly lighted places or while washing face at washbasin.

Diabetes, hypertension, cardiac problems, sleep disorders, BPPV, dementia etc are age
related associates which require multiple medicines which increase chances of fall.
Sedatives, pain management medicines (pregabalin, gabapentin),antidepressants etc
can cause drowsiness & falls.
Postural hypotension, cardiac arrhythmias are important causes of syncope & fall in
st
elderly patients. Even seizures may start 1 time at old age & can cause fall.
In elderly person with repeated falls, you have to decide the cause of fall. Is it brain,
muscles, peripheral nerves, autonomic nervous system, heart, postural fall, vision,
st
hearing or joints ? Fall can be 1 time due to acute cerebrovascular ischaemia, TIAs, ICH,
or syncope.
Falls in elderly can cause fractures, fracture vertebrae, head injuries. Sometimes subtle
head injury can cause subdural hematoma later on. There is a problem in recovering
from fractures due to associated osteoporosis, sometimes due to fragile bones it may
not be possible for a person to walk independently, or more falls & fractures due to
instability. Besides aging osteoporosis can be accentuated by many of the drugs used in
elderly persons.

Daily exercises, balanced diet, adequate sleep, proper medicines, vitamin
supplementation etc, tailor-made to make you healthy at brain, muscles & bones, can
prevent falls.
Please find out the cause if you feel unstable. Use stick, hearing aids, specs, assistance
whatever is a must but avoid falls!

Nov
V 23 November-2019ember-2019
Vol. : 18 - Issue : 1ol. : 18 - Issue : 1