Sunday, January 15, 2006

falls

People over 65 constitute the age group most affected by home accidents, accounting for 9,900 fatalities per year and 43 percent of all accidental fatalities in the home. As people age, falls become an increasingly significant cause of death. They overtake motor vehicle accidents by age 75-79, when the mortality rate from falls reaches 36.9 per 100,000 compared to 30.5 for motor vehicle accidents. At age 80-84 the death rate from falls climbs to 79.2 per 100,000 compared to 32.3 for motor vehicles, and by 85 it reaches 186.3 per 100,000 compared to 24 for motor vehicles. Women and men about equal one another in deaths caused by falls, with stairs the most prominent place of injury. Misuse of alcohol and acute and chronic health problems are also factors in 42 percent of these deaths but it is estimated that environmental hazards enter the picture in 45 percent of the cases.
Physical disorders that often appear to produce falls include recently acquired gait disorders (such as learning to walk after hip replacement, leg muscles weakened after a bed stay, and imbalance produced by drugs and alcohol). In terms of environmental causes, stairways represent the most serious danger because visual control of movements is vitally important at top steps where lighting is often not adequate. Remedies for stairway problems include proper lighting, installation of handrails, efficient stair design (suitably deep treads and a gradual rather than steep incline), and removal of stairwell features that may distract the walker's attention. Other factors causing home falls include loose and slippery rugs, poorly secured carpets with edges that can cause tripping, and raised thresholds in doorways that cause stumbling. Loose slippers and robes may appear comfortable and suitable for scuffing about, but these too can be a hazard. An excellent discussion of the causes and ways of avoiding falls written in nontechnical language for the lay person appears in an article in the Harvard Medical School Health for December, 1989, (Vol. 15:2). Here the author makes an important concluding observation: There is some evidence that remaining in good physical condition, including graded exercise and gait training for those who need it, maintains the leg muscle strength and good balance that can help to prevent falls.
Stems, H. L.; Barrett, G. V.; and Alexander, R. "Accidents and the Aging Individual," in Birren, J. E., and Schaie, K. W., eds. Handbook of the Psychology of Aging, 2nd ed. New York: Van Nostrand Reinhold Company, 1985.

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