Falls in the elderly

This is an automatically translated article.

The article was written by Emergency Resuscitation Doctor - Emergency Resuscitation Department - Vinmec Phu Quoc International General Hospital.

1. Falling in the elderly: Unpredictable accidents

Fall is not only a cause of death but also a factor that reduces quality of life, limits mobility, exposure, and adversely affects daily lifestyle.
Falls are very common accidents: every year, this accident accounts for 25% of people 70 years old, 35% of people ≥ 75 years old living in their families, 50% of these people fall > 1 time a year. More female falls than men may be due to weak muscle strength (male: 12%, female: 16.2%).
Consequences of falls can be mild (male: 48.5%; female: 51.5%), but can also be severe (fracture, trauma, loss of consciousness ...) , number of uninjured falls for men: 30.3%, for women: 32.6%.

2. Common causes and risk factors for falls

2.1 Intrinsic Factors Chronic risk factors: All diseases that damage the structure and functioning of the musculoskeletal system are precursors that can lead to falls: Parkinson's disease, paralysis, weakness, weakness in the joints of the legs. Diseases affecting the senses and sensory activities (vision, hearing, balance function, self-perception... are also prerequisites leading to unsteady walking, causing falls. Short-term effects: Like acute diseases, decompensated states, although short-lived, are very dangerous, unpredictable, occur suddenly, the patient as well as those around him. unforeseen circumstances such as: orthostatic hypotension; Stokes-Adams bradycardia; taking drugs that affect mental status, balance, muscle tone, drugs that dehydrate, lose electrolytes, leading to low blood pressure 2.2 Exogenous factors Background, working surface of the elderly is not suitable, rough, has abnormal ledges, unpredictable, there are slippery places, there are too many stairs high light not enough to see clearly Combination of factors: There are old people who don't know their strength, weak in their health, have adventurous activities
Climb tall trees, Climb up on the high chair alone to reach for the things that are left on high. Go fast on the stairs: going down is more dangerous than going up. About 10% of falls occur when going up and down stairs. Play sports according to the movement, without the health check and assessment, not under the guidance of the responsible person.

3. Injuries caused by falls

The process of accumulating age brings about many profound changes in the body, in which changes are related to damage caused by falls, which is thinning of bones (osteoporosis). Osteoporosis can begin at age 55, or later after age 70. The less physical activity, the less, the sooner the thinning of bones appears, the faster it develops. Due to the lack of bone, the bone's resistance to injuries is poor, so it is easy to break bones. Among the types of fractures, in the elderly, it is necessary to pay attention to the fractures that cause long-term bed immobilization such as pelvic fractures, femoral neck fractures, high mortality rate and many complications due to inactivity: inflammation. Pulmonary embolism, pressure ulcers... There are cases of falls causing cardiac arrest, traumatic brain injury, spinal cord injury, multiple organ rupture injuries...

4. Fall prevention in the elderly

Falling when it occurs poses two types of questions for the physician: whether the accident occurred due to external circumstances, inappropriate living environment or there was an internal disease that caused the body to lose balance and had to fall. In either case, a full assessment of the injury caused by a fall is necessary, and prompt management of the medical conditions that predispose to the fall and the likelihood of these situations recur.

On that basis, propose measures to prevent falls: explain, educate and guide the elderly to properly understand their health characteristics. But pay attention to the content and explanation so that the elderly as well as their families are not too worried about fear of movement, fear of exercise, leading to a state of inactivity, a risk factor for the disorder. metabolism, overweight, thinning of bones... Remind elderly people about movements to avoid such as climbing, on easy to fall objects such as chairs, ladders, tall trees, ... such as running and jumping on empty places. flat, rough and slippery places; encourage and encourage the elderly to practice according to their strength, according to their age, in familiar and stable environmental conditions. Help to rearrange furniture in the interior to make traveling comfortable and convenient, reducing obstacles that can cause tripping and falling. Elderly people and their families should not think of falls as a matter of chance. Falling is a regular phenomenon, but not a fate. The older the age, the weaker the body, the less convenient living environment, the more likely to fall. But if you have a sense of exercise from a young age, beware of adverse terrains, and avoid dangerous movements, you can avoid falling. Most proactively, the elderly are guided on the above-mentioned issues, and the elderly's families are also knowledgeable and conscious about protecting their loved ones, falling situations will not occur. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also stands out for its examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space.
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