Did you know falls are seen as a serious public health issue? It’s not surprising when we consider that falls significantly contribute to deaths resulting from accidental injury (1). While anyone can take a tumble, different populations, such as those living within certain settings or with specific health conditions, face factors that increase their risk of experiencing falls and their potential consequences. Community-dwelling older adults and people living with Parkinson’s disease or cognitive impairments are three examples of these populations. Fortunately, strategies including environmental programs, exercise, and medications are available to help these populations reduce their risk of failing, but are they effective (2-4)? Click on the links below to learn more.
1. Community-dwelling older adults
For older adults living in the community, the presence of hazards in their surrounding environment, like bad lighting or cluttered walking surfaces, can increase their risk of falling (2;5;6). Research shows that environmental programs that remove fall-hazards from the home reduce the number of falls and the number of fallers in this population. This benefit is specific to older adults who are at high risk of falling, such as those who can’t perform daily activities on their own, have been recently hospitalized, or have fallen within the last year. More research is needed on other environmental programs, like those involving assistive technologies and education, as uncertainty around their effectiveness remains (2).
2. People living with Parkinson’s
Disease severity, history of previous falls, and poor lower limb strength are factors that increase the risk of falls in people living with Parkinson’s (3;7-13). Research shows that exercise and cholinesterase inhibitors, which are medications used to prevent or delay cognitive impairment, can decrease the risk of falls in this population. Exercise, specifically, may also help to reduce the number of people with Parkinson’s who fall one or more times and improve health-related quality of life by small amounts. Along with these positive results, it should be noted that the findings for exercise are relevant to those with mild-to-moderate Parkinson’s, while the findings for cholinesterase inhibitors are relevant to people with severe Parkinson’s. In terms of safety, the use of cholinesterase inhibitors may increase the risk of certain negative side effects. More research is needed to support these findings and paint a better picture of safety and how to best deliver these strategies (3).
3. People living with cognitive impairment
People living with Alzheimer’s disease and other types of dementia are often dealing with multiple factors that increase their risk of falling. These include underlying medical conditions, poor cognition, and side effects from medications they are taking (1;4). Research shows that cholinesterase inhibitors may reduce the risk for falls, increase the risk of fainting, and have no effect on the risk of fractures or accidental injury in this population (4).
While various falls prevention strategies exist, any plan to help you prevent falls should be developed in collaboration with your healthcare team. Together you can discuss and consider your risk of falling, underlying health and living conditions, and whether the benefits of specific strategies outweigh the risks for you as an individual.
