The leading cause of injury-related deaths among older adults in the U.S. may surprise you — it’s falls.
From 2007 to 2016, the number of seniors dying from falls steadily increased each year. These accidents often occur in our most familiar surroundings — close to home.
About 1 in 4 adults aged 65 or older report falling each year in America. In just one year alone — 2016 — more than 29,000 older adults died as a result of a fall, according to the federal Centers for Disease Control and Prevention.
These numbers helped spur researchers at the University of Washington and Kaiser Permanente’s Washington Health Research Institute to try to find ways to reduce this risk.
They want to know if reducing or eliminating benzodiazepines, medications prescribed for anxiety and insomnia and often taken with opiate pain relievers, can cut falls among seniors.
Benzodiazepines include drugs such as Xanax, Klonopin and Valium.
“If you’re on these medications you want to take them for the shortest time possible, recognizing that you are at increased risk of falls,” said Dr. Elizabeth Phelan, who directs the Fall Prevention Clinic at Harborview Medical Center in Seattle.
Younger people have a lot of built-in reflexes that help them remain upright. Those nerve and muscle systems become less strong as people age, said Dr. Eric Larson, who leads Kaiser’s health research institute.
Medications can further dampen reflexes by hampering the chemicals that go between cells in the brain, tilting the balance against someone being able to react and stop a fall, he said.
More people than ever are living into their 80s and 90s, increasing the potential for falls. “This project is super important to being able to address this on a mass scale,” Larson said.
The goal of the study, funded through a $3 million CDC grant, is to inform Kaiser patients of the risk posed by some medications, reduce their use and track if that in turns reduces falls.
A pharmacist and physician will check a patient’s medications to see if there are any that could cause falls or are no longer helping the patient.
Kaiser is expected to begin asking patients from their 25 clinics statewide to join the study later this year. Patients must be 65 or older.
The study will involve adults who are chronic users of benzodiazepines and opiate pain relievers.
“The longer the initial prescription is for, the more likely a person can be turned into a chronic user of these medications,” Phelan said.
Patients will be given tips on what alternatives they could use to help manage their pain. “We don’t pay enough attention to safer alternatives,” she said, such as taking the topical form of over-the-counter medications such as Advil or Motrin.
Patients also may be referred to non-medication alternatives to reduce chronic pain, such as physical therapy, and perhaps yoga, acupuncture and tai chi, she said.
A Canadian program informing patients of the risk to falls from some medications has shown results. Brochures were mailed out describing the problems benzodiazepines can create and how to gradually reduce their use.
About one-quarter of patients were able to cut their use after they receiving the mailing, Phelan said.
The idea is to taper gradually to get to a lower dose or off the medications completely. “Even getting on a lower dose can be beneficial,” she said.
Another key factor in preventing falls is muscle strength, the foundation of good balance, Phelan said.
A sign that you’re at risk for falls if is you can’t stand up from a regular height chair without using your arms to help support you.
To decrease the risk of accidents, try to make strengthening exercises, such as squats or heel-toe walks, part of your daily routine, Phelan said.
Most people have some discomfort as they age due to injuries, overuse and degenerative diseases. The goal with pain management is allowing people to function, “not getting it to zero,” she said.
Sharon Salyer: 425-339-3486 or firstname.lastname@example.org.
Fall prevention tips
Many people who fall have extremely weak muscles that hinder their ability to get out of bed or a car. Simple daily exercises can help. These include:
Sit-to-stand exercises. Practice standing up out of a chair without using your arms.
Supported squats. Place a chair at a point below your bottom as you squat so you won’t land on the floor if you have an uncontrolled sit.
Make balance and strength exercises a daily routine. This could include alternating standing on one leg while brushing your teeth or doing heel-toe walking down a hall.
Source: Dr. Elizabeth Phelan
This article has been modified to show the correct age patients must be to join the Kaiser study — 65 or older.