Fall Prevention Study for
Older Adults

Falling is a major issue for older patients and their families. Their increased bone fragility makes them particularly vulnerable to physical damage, and their overall muscular weakness, reduced balance, and increased medication intake make them more susceptible to falls. The complications that can come from a fall at a later stage of life can be tremendous; life-long injuries, complete loss of independence or even death are possible outcomes of this common yet dangerous event in the life of elderly people.

American researchers developed an intervention program that aimed to reduce the frequency of falling in their older patients, as well as modifying potential risk factors such as polypharmacy and poor muscle strength and/or balance. They discovered that after applying the program on their patients, gait and balance had improved, their knowledge on polypharmacy and unnecessary medications rose, and the overall probability of suffering from a fall was reduced in a significant manner.

The Stay Standing fall prevention program was a multipart intervention conducted by experienced nurse practitioners in the United States of America. 18 patients with an average age of 75 years were visited and followed during a year to practice a predetermined exercise protocol and assess their improvement in their risk of falling.

The gait and physical balance of the patients were assessed with physical exercise tests, like the Timed-Up-and-Go-Test (TUG), the 30-second Chair Stand Test, and the 4-Stage Balance Test. Their knowledge about the risks of polypharmacy, potentially inappropriate medications (PIMs) and medication reduction was also assessed by the nurse practitioners with an evaluation instrument designed by geriatric-care experts.

Another key part of the program was the educational component, in which the nurses would teach patients about the several factors that can influence their risk of falling. In the end, they were also questioned about whether they had experienced falling since the last visit.

Overall, the results were highly positive after 1 year of trimestral visits. For example, the gait and balance of patients were increased after the 12-month period. They improved their results in the 30-Second Chair Stand and in the 4-Stage Balance Test. This meant, for example, that one 68-year-old lady increased the number of times she could stand up from a chair in 30 seconds with her hands over the opposite shoulder, from 3 to 8.

Another participant went from 5 to 8 seconds in their ability to stand on 1 foot without any help in the balance test. It was also clear at the end of the study, that participants had increased their overall understanding of the risks of polypharmacy and PIMs, as made evident with the results of the tests conducted before and after the intervention.

Ultimately, the most important factor of all was the frequency with which these patients were suffering from falls. After 12 months, results reported a reduced risk of falling for the participants. Patients in the intervention suffered from falls 0.35 times on average, compared to 1.42 times for people who were not enrolled in the prevention program. This reduction was the desired outcome at the beginning of the experiment, and fortunately, it was achieved.

Falling can be tremendously dangerous for older people. There are many influencing factor to this problem, such as their deteriorated physical condition (less muscle strength and body balance, loss of vision and hearing, postural hypotension), health-care-related factors like increased use of medications that can cause falling predisposing states (dizziness, sleepiness, sedation) or external factors like steps and misplaced objects in the household. Preventing falls is without a doubt one of the most important health care practices for older adults, and this should be promoted both by health professionals as well as by their families. It is clear that prevention programs that include exercise and education can be of great help to reduce this undesired and potentially serious event.

Great resources can be found on the internet to reduce the risk of falling, for example, the STEADI program for older adults' fall prevention (used as the base for this study) by the CDC, which can be found in this link https://www.cdc.gov/steadi/patient.html.

Checklists, exercise guides to improve and assess strength and balance, and recommendations are available there. In the end, the most important thing is that we all contribute to reducing the frequency of falls to as low as possible in our homes and hospitals, which as we now know, can be achieved with applied exercise and education in our homes.

References:

A Longitudinal Fall Prevention Study for Older Adults, Karen H. Frith, PhD, RN, Amy N. Hunter, DNP, FNP-BC,
Sharon S. Coffey, DNP, FNP-C, and Zaheer Khan, MD

Photo by Jack Finnigan on Unsplash