Five strategies you can recommend to your geriatric patient within your scope of chiropractic practice, that will allow him or her to achieve a continued sense of wellness.

Fall Prevention

     The risk of falling increases as we get older and so does the risk of sustaining a physical injury. Fall rates are higher among those living in nursing homes as opposed to those who live in the community. About 10% of visits to emergency rooms are due to falls which includes injuries like hip fracture, serious soft tissue injury, subdural hematoma and head injury. Studies show that falls among individuals aged 65 and over lead to high rates of morbidity and mortality. According to WHO (World Health Organization), The mortality rate for this age group in Canada is 9.4 per 10000 population.  Although the injury rates are similar among elderly men and women, women are more likely to suffer from fractures. Not all the falls are the same and not everyone falls for the same reason. There are a number of factors that may contribute to the increased risk of falls among older population. These risk factors could be biological/medical, behavioral, environmental, or socio-economical [2,3,5,6].

     Biological risk factors contributing to increased fall rates could be non-modifiable like age, sex, and race. Or they could be somewhat modifiable like gait and balance problems, osteoporosis, arthritis,  visual impairment, muscle weakness leading to loss of strength and flexibility, age-associated physical and cognitive decline, orthostatic hypotension, peripheral neuropathies (in particular diabetes, where there could be loss of sensation in the legs), cardiovascular disease like transient ischemic attack, upper motor neuron disease like MS or Parkinson’s disease, depression, or dementia. Furthermore, among moderately to strongly associated biological factors are being older than 80 and female [2,3,4,6].

     Behavioral risk factors include multiple medication use, previous history of falls, excessive alcohol intake, lack of exercise, inappropriate footwear, ill-advised or high risk activities like climbing. Lack of physical activity combined with poor diet increase fall rates among older individuals. Studies have shown that regular physical activity of at least 30 minutes daily or most days of the week is an important factor in maintaining the muscle strength, flexibility, aerobic endurance and balance as well as a good cognitive function [3,4,6].

     Environmental risk factors consist of both within and outside the home causes. Seniors who live independently within the community are subject to more environmental risk factors. Among risk factors found within the home are loose area rugs; inadequate lighting and dark rooms; lack of handrails by stairs, toilets, sinks, or bathtubs; slippery floors and stairs; poor building design. Among the factors outside the home are poorly designed or maintained stairways or rails; cracked, uneven, and poorly maintained sidewalks [3,4,6].    

     Social and Economical risk factors are not directly linked to higher fall rates. However, factors like low income, level of education, lack of supportive social network, or lack of access to health care services will put the older population at a higher risk of developing chronic conditions and hence increase the fall rates. Furthermore, individuals who are economically or socially at a disadvantage, who may consequently not be well educated, may be negatively effected in terms of physical health and a good diet [4,6].

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