June 1, 2018
Falls are common in older men and women, and can lead to prolonged hospital stays and serious medical complications. Falls are a particular problem in those with Alzheimer’s disease, according to a new report in the Journal of the American Geriatrics Society.
Reviewing studies of falls and older adults, the researchers note that one in three Americans aged 65 and older experience a fall each year. The rate is more than doubled in those with Alzheimer’s disease and other forms of dementia: 70 percent of those with dementia experience at least one fall each year. The researchers also found that those with mild cognitive impairment, a condition characterized by a noticeable decrease of memory and thinking skills that often precedes full-blown Alzheimer’s, are more likely to have a fall.
Those with Alzheimer’s disease are more likely to have gait and balance problems, and may have trouble walking. They also often have problems with attention and focus as well as making decisions. So it is not surprising that they are more likely to fall than their cognitively normal peers.
And falls can be particularly problematic in someone with Alzheimer’s disease. Those with early signs of dementia who live alone are at higher risk after a fall of not getting immediate help, increasing the likelihood that they might die as a result of a fall. Those with memory and thinking problems are also five times more likely to be admitted to long-term care facilities after a fall.
So what can be done to help prevent falls, or to minimize their impact, in someone with Alzheimer’s disease?
The authors suggest that several measures may help.
Keep a list of all of the medications you take — both non-prescription and prescription. This includes any supplements that you take, such as vitamins. Many drugs can lead to drowsiness and other side effects that can diminish attention and increase the risk of falls. Keep a list of medications with you, so that your doctor can check for interactions or side effects if any new medications are added to your regimen.
Consider strength and balance exercises. Regular exercise and physical activity, even if it is light, can help to maintain muscle strength and balance and may help to minimize the risk of falls. Studies have shown that treadmill training can reduce the risk of subsequent falls. Tai chi, too, can be a good way to build balance.
Try brain training. Studies have shown that cognitive training can enhance the benefits of exercise. Adults with mild cognitive impairment who did treadmill training that was enhanced with a virtual reality component, for example, were less likely to fall. The virtual reality component consisted of a screen in front of the treadmill displaying a path with obstacles and targets that was designed to expose participants to similar real-life situations that might make them prone to falls.
Fall-proof your home. Most falls occur in the home. Take care to remove any stacks of papers, loose carpets, extension cords or dropped clothing items that may be on the floor. Remove as many as possible. Avoid spills of water or other liquids in the kitchen or bathroom, or wipe them up promptly, since they can be slippery and increase the risk of falls. Put the lights on at night and do not assume that you know your way in the dark, be focused when getting into challenging activities (for example, getting into the bathtub, or going up or down the stairs), and wear shoes that are easy and comfortable without being loose.
By www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Manuel Montero-Odasso, MD, PhD and Mark Speechley, PhD: “Falls in Cognitively Impaired Older Adults: Implications for Risk Assessment and Prevnetion.”Journal of the American Geriatrics Society, Vol. 66, pages 367-375, March 2018